An Anatomic Study of the Relationship Between the Iliocapsularis Muscle and Iliofemoral Ligament in Total Hip Arthroplasty

Konno, Kenji; Hagiwara, Shigeo; Nakamura, Junichi; Suzuki, Takane; Eguchi, Yawara; Ohtori, Seiji

doi:10.1016/j.artd.2021.09.010

Cited by 2 publications

(5 citation statements)

References 25 publications

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“…To further evaluate the ICm prevalence in the human body, one redundant donor data set was excluded in addition to 14 publications, which were either reviews, technical notes, or case studies. A total of 13 studies, published between 1950 and February 14th, 2022, investigated the prevalence of the ICm in a total of 521 anterior human hips (Babst et al, 2011; Baker et al, 2022; Elvan et al, 2019; Fagotti et al, 2020; Haefeli et al, 2015; Konno et al, 2021; Lawrenson et al, 2017; Lawrenson et al, 2020; Philippon et al, 2014; Walters et al, 2014; Wang et al, 2021; Ward et al, 2000; Xu et al, 2021). The ICm was present in 99%, or 518, hips which are in line with a recently published systematic review and meta‐analysis that analyzed dissection results of six studies, reporting a pooled‐prevalence rate of 98.7% (Keet et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

“…ATBs. The surveys suggest that the muscle is rarely appreciated by general clinicians and anatomy educators, while the recent PRL suggests that hip-specific surgeons, who must account for the muscle's presence and functional importance when performing anterior hip procedures, have come to prioritize the muscle over the past decade (Camenzind et al, 2018;Fagotti et al, 2020;Harris, 2016;Konno et al, 2021;Philippon et al, 2014;Siebenrock et al, 2015;Spiker et al, 2021;Xu et al, 2021). In contrast to these conflicting findings, the ICm was a constant in the dissections performed in this study in all previous surgical and dissection studies, Note: A positive result in the educator survey was recorded by including iliocapsularis in the answer to the question "Which of the following structures do you teach to your students?…”

Section: Discussionmentioning

confidence: 99%

“…These exclusions resulted in 28 PRL articles which included the ICm. Of the 28 publications mentioning the ICm, 19 highlighted the morphology and proposed functional roles of the muscle (Babst et al, 2011;Baker et al, 2022;Das & Singh, 1950;Elvan et al, 2019;Haefeli et al, 2015;Hammoud et al, 2014;Keet et al, 2021;Konno et al, 2021;Lawrenson et al, 2017Lawrenson et al, , 2019Lawrenson et al, , 2020Philippon et al, 2014;Pourcho et al, 2015;Retchford et al, 2013;Ricci & Özçakar, 2019;Saito et al, 2021;Walters et al, 2014;Wang et al, 2021;Ward et al, 2000). Nine additional studies reported the presence of the ICm using clinical scenarios consisting of surgical interventions and diagnostic imaging (Agten et al, 2016;Camenzind et al, 2018;Fagotti et al, 2020;Harris, 2016;Kalhor et al, 2021;Siebenrock et al, 2015;Spiker et al, 2021;Wyatt et al, 2017;Xu et al, 2021).…”

Section: Primary Literature Searchmentioning

confidence: 99%

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Iliocapsularis: An exploration of the muscle and its omission in education

Breckling¹,

Katrikh

Jones

et al. 2022

Journal of Morphology

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Anterior hip joint musculature is classically characterized to include iliacus, psoas major, rectus femoris, and sartorius muscles. A lesser‐known muscle, iliocapsularis muscle (ICm), has made infrequent appearances in the literature for the last ~70 years, but potentially has important functional and clinical value. The purpose of this study is to review the historical prevalence of the ICm in peer‐reviewed literature (PRL), further explore the prevalence of the muscle in current anatomical textbooks (ATBs), characterize the muscle with a new series of dissections, assess the muscle's perceived importance to clinicians and educators, and comment on the possible functional significance of the muscle. The ICm was mentioned in 28 peer‐reviewed articles and the muscle was present in 518 of 521 (99%) dissected hips in 13 publications which assessed prevalence. In an audit of 30 recently published ATBs, three texts mentioned the ICm. In 28 anterior hip dissections performed in the current study, the muscle was present in all hips. Anatomy educators were surveyed to determine if the ICm was presently taught in their curricula, and clinicians of various specialties were surveyed regarding their perceptions of the ICm and its clinical relevance. The ICm inclusivity within anatomical curricula from educators reported 8.5%, while 4% of clinicians reported trainees should have an educational background of the ICm. This study confirms that while the ICm is present within PRL, and is ubiquitous amongst human‐donor dissection, the ICm is not mentioned in most ATBs and is absent in the vast majority of anatomical curricula. Lack of inclusion in curricula may lead to a perceived insignificance to currently practicing clinicians despite the potential functional importance at the hip. This discordance suggests that the ICm should be included in ATBs and anatomical curricula so that future clinicians can consider the ICm when evaluating and treating patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Primary Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Iliocapsularis: An exploration of the muscle and its omission in education

Breckling¹,

Katrikh

Jones

et al. 2022

Journal of Morphology

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…The hip joint is stable posteriorly due to its ball-and-socket joint geometry supported by the acetabular labrum and intra-articular and extra-articular ligaments [ 8 ]. On the other hand, anterior stability comparatively relies on soft tissue such as the iliopsoas muscle to ensure joint mobility [ 8 ]. Patients with hip OA have limited ROM due to irreversible degeneration of the acetabulum, femur, and labrum with or without femoral head ligament rupture [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Association Between Anterior Hip Capsule Thickening and Sagittal Pelvic Alignment Among Patients With Developmental Dysplasia of the Hip

Yoshikawa,

Tamaki,

Kimura

et al. 2024

Cureus

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Introduction: The pathogenesis and pathology of secondary osteoarthritis (OA) of the hip, which is mainly due to developmental dysplasia of the hip (DDH), in Japan are obscure. There are some reports on the thickening of the hip capsule, but the relationship between the thickness of the hip capsule and the pelvic alignment due to hip deformity is not well known. This research investigated whether the capsular thickness of female DDH patients was related to pelvic alignment. Methods: This single-center cross-sectional study included female patients aged 50-79 years (n=13) who had undergone primary total hip arthroplasty (THA) due to secondary hip OA with a background of DDH. The part of the hip capsule including the iliofemoral ligament was resected and measured directly with a digital caliper. The Sharp angle, center-edge (CE) angle, sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis angle (LLA) were measured with an X-ray image to investigate the relationship between the capsular thickness and the pelvic posture. Results: Pearson's correlation coefficient showed a negative correlation between hip capsular thickness and Sharp angle (r=-0.57, p>0.05). No significant correlation was found between the thickness of the hip capsule and the sagittal X-ray parameters including SS, PT, PI, LLA, and CE angle in the coronal plane. Conclusion: The thickness of the hip capsule is moderately associated with the Sharp angle on the coronal plane. The results of this study suggest that the thickness of the joint capsule does not necessarily relate to the degenerative process among patients with DDH and the process can be complex to apply two-dimensional postural indices for the explanation.

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An Anatomic Study of the Relationship Between the Iliocapsularis Muscle and Iliofemoral Ligament in Total Hip Arthroplasty

Cited by 2 publications

References 25 publications

Iliocapsularis: An exploration of the muscle and its omission in education

Iliocapsularis: An exploration of the muscle and its omission in education

Association Between Anterior Hip Capsule Thickening and Sagittal Pelvic Alignment Among Patients With Developmental Dysplasia of the Hip

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