Embryology of the Human Hip Joint

Abstract

This paper has arisen from a need for more exact knowledge of the development of the normal human hip joint than, could be gained from the literature and text-books of embryology. It The formation of the acetabulum, head and neck of the femur, the ligamentum teres, retinacula of Weitbrecht, glenoid labrum, the synovial membrane, and the transverse acetabular ligament are described in detail. The entry of blood vessels into the head and neck of the femur and the suggested predisposition of the head of the femur to dislocation in one embryo are noted in brief.The illustrations of the 6.75 to 45 mm. embryos have been selected from the excellent material available in the Minot Embryological Collection of the Harvard Medical School. Six embryos, 45 mm., 70 mm., 81 mm., 90 mm., 167 mm., and 237 mm. respectively, were cut in serial sections in the Laboratory of Pathology of The Children's Hospital, Boston. The observations on blood vessels and later development have been made from these sections. The crown rump measurement as correlated by Keibel and Mall has been used as a standard. LiteratureWriting on the embryology of the extremities K1lhiker," in 1861, made a statement to the effect that "the ground work of all the bones of the extremities arises at first from one single undifferentiated 'body. When cartilage formation first begins throughout this mass, it will organize itself into several parts so that it will develop into just as many single cartilages or bones." This simple forceful statement is the essence of skeletal embryology.

The Asymmetric Profile of the Acetabulum

“…At birth, the pelvis is still partly cartilaginous, notably the entire iliac crest, the acetabular floor, and its inferior margin. The acetabulum is still a triradiate stem forming a Y-shaped epiphyseal articular surface but continues to grow and adapt structure to function until maturity [26,30,38].…”

Hemispheric cups do not reproduce acetabular rim morphology

“…At birth, the pelvis is still partially cartilaginous, most notably the entire iliac crest, the acetabular floor, and its inferior margin. The acetabulum is still a cartilaginous cup with a triradiate stem, forming an articular surface with a Y-shaped epiphyseal plate between the ilium, ischium, and pubis (Strayer 1971, Watanabe 1974. Ossification of the pelvis continues from three primary centers in the innominate bones, and around puberty secondary centers appear in the iliac crest, ischial tuberosity, and pubic symphysis.…”

Acetabular fracture assessment in four different pelvic trauma centers: have the Judet views become superfluous?

“…The development of the acetabulum starts around the 6 th week of gestation when the anlage for the ilium, ischium and pubis is formed from the mesoderm 3 . The cartilages then proliferate around the femoral head, deepening the acetabulum considerably 4 . The hip joint is fully developed by the 8 th week of gestation.…”

“…51 patients were excluded; 30 patients were deceased before FU, 11 patients were not followed because of serious medical co-morbidities and 10 were lost to FU before one year, leaving a total of 185 patients (186 hips) to be analyzed. The average FU was 9 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) years. The patients had a mean age of 49 …”