Functional Anatomy of the Hip Joint.
THA
dislocation
functional safe zone
spine-hip relationship
spinopelvic imbalance
total hip arthroplasty
Journal
The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
09
04
2020
revised:
23
07
2020
accepted:
27
07
2020
pubmed:
26
8
2020
medline:
29
4
2021
entrez:
26
8
2020
Statut:
ppublish
Résumé
The functional anatomy of the osteoarthritic hip joint in the sagittal plane has not been defined. The purpose of this study was to define the functional anatomy of the hip using clinical and radiographic analyses. 320 hips had preoperative standing and sitting lateral spine-pelvis-hip X-rays. Radiographic pelvic measurements were pelvic incidence (PI) and sacral slope (SS), and hip measurements were anteinclination (AI) and pelvic femoral angle (PFA). Pelvic tilt (PT) was calculated as PI-SS. A triangle model was created from the clinical data that illustrates the functional motion of the hip during postural changes from standing to sitting. Pelvic motion was coordinated with hip motion, even with spinopelvic imbalance and stiffness. Pelvic motion (ΔSS) varied for all 5 types of imbalance, but pelvic motion (ΔSS) and acetabular motion (ΔAI) changed with a 1:1 ratio and inversely with femoral motion (ΔPFA) with a 1:1 ratio. The triangle model showed similar results with ΔSS, ΔPT, and ΔAI changing in a 1:1:1 ratio, and femur motion inversely changing with a 1:1 ratio. The functional anatomy of the hip joint can be visually illustrated using a triangle model. Pelvic angles SS, PT, and AI change in unison, whereas femoral motion (ΔPFA) changes inversely with pelvic motion (ΔSS) in a 1:1 ratio. This coordinated mobility explains the limitations of the Lewinnek safe zone, which include only the acetabulum.
Sections du résumé
BACKGROUND
The functional anatomy of the osteoarthritic hip joint in the sagittal plane has not been defined. The purpose of this study was to define the functional anatomy of the hip using clinical and radiographic analyses.
METHODS
320 hips had preoperative standing and sitting lateral spine-pelvis-hip X-rays. Radiographic pelvic measurements were pelvic incidence (PI) and sacral slope (SS), and hip measurements were anteinclination (AI) and pelvic femoral angle (PFA). Pelvic tilt (PT) was calculated as PI-SS. A triangle model was created from the clinical data that illustrates the functional motion of the hip during postural changes from standing to sitting.
RESULTS
Pelvic motion was coordinated with hip motion, even with spinopelvic imbalance and stiffness. Pelvic motion (ΔSS) varied for all 5 types of imbalance, but pelvic motion (ΔSS) and acetabular motion (ΔAI) changed with a 1:1 ratio and inversely with femoral motion (ΔPFA) with a 1:1 ratio. The triangle model showed similar results with ΔSS, ΔPT, and ΔAI changing in a 1:1:1 ratio, and femur motion inversely changing with a 1:1 ratio.
CONCLUSION
The functional anatomy of the hip joint can be visually illustrated using a triangle model. Pelvic angles SS, PT, and AI change in unison, whereas femoral motion (ΔPFA) changes inversely with pelvic motion (ΔSS) in a 1:1 ratio. This coordinated mobility explains the limitations of the Lewinnek safe zone, which include only the acetabulum.
Identifiants
pubmed: 32839062
pii: S0883-5403(20)30858-5
doi: 10.1016/j.arth.2020.07.065
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
374-378Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.