A quantitative assessment of the insertional footprints of the hip joint capsular ligaments and their spanning fibers for reconstruction

Abstract

Quantitative descriptions of the hip joint capsular ligament insertional footprints have been reported. Using a three-dimensional digitizing system, and computer modeling, the area, and dimensions of the three main hip capsular ligaments and their insertional footprints were quantified in eight cadaveric hips. The iliofemoral ligament (ILFL) attaches proximally to the anterolateral supra-acetabular region (mean area = 4.2 cm(2)). The mean areas of the ILFL lateral and medial arm insertional footprints are 4.8 and 3.1 cm(2), respectively. The pubofemoral ligament (proximal footprint mean area = 1.4 cm(2)) blends with the medial ILFL anteriorly and the proximal ischiofemoral ligament (ISFL) distally without a distal bony insertion. The proximal and distal ISFL footprint mean areas are 6.4 and 1.2 cm(2), respectively. The hip joint capsular ligaments have consistent anatomic and insertional patterns. Quantification of the ligaments and their attachment sites may aid in improving anatomic repairs and reconstructions of the hip joint capsule using open and/or arthroscopic techniques.

Hip Capsular Reconstruction Using Dermal Allograft

“…It is composed of the ilioischial, iliofemoral, and pubofemoral ligaments, as well as the zona orbicularis. 8 The iliofemoral ligament is located between the 12-and 3-o'clock positions (thickest at the 2-o'clock position) on the acetabular clock-face anatomy and is the most important stabilizer for hip extension and external rotation. 9 Moreover, it is the most commonly incised ligament to gain access to the joint during hip arthroscopy.…”

Anterior Capsule Reconstruction of the Native Hip: A Technique Guide

“…The docking sites for the graft were chosen to mimic the native iliofemoral ligament. 4 The proximal docking area is located on the outer table of the pelvis just adjacent to the anterior inferior iliac spine abutting the anterolateral acetablulum. 4 This 2 Â 2-cm area is decorticated using an oscillating saw.…”

“…4 The proximal docking area is located on the outer table of the pelvis just adjacent to the anterior inferior iliac spine abutting the anterolateral acetablulum. 4 This 2 Â 2-cm area is decorticated using an oscillating saw. A 5.5-mm suture anchor (CrossFT; ConMed) is then deployed in the decorticated docking site in a distally based direction to allow for better pullout strength, a theory borrowed from the shoulder deadman's angle (Fig 9).…”

Microinstability of the hip: a previously unrecognized pathology

“…Its lateral arm follows a horizontal route along the neck of the femur to insert at the anterior greater trochanteric crest, whereas the medial arm inserts distally at the intertrochanteric line 18 . The ischiofemoral ligament originates at 10:15 clock position on the acetabulum 17 and follows a spiral route to insert at the base of the greater trochanter 19 . The pubofemoral ligament arises at the 4:44 clock position on the acetabular rim 17 and blends with the medial arm of iliofemoral ligament, lacking a femoral attachment site 5 .…”