New Findings in Hip Capsular Anatomy: Dimensions of Capsular Thickness and Pericapsular Contributions

Walters, Brian L.; Cooper, John H.; Rodríguez, José A.

doi:10.1016/j.arthro.2014.05.012

Cited by 74 publications

(117 citation statements)

References 26 publications

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“…This band contributes to the hip capsule, where it is most thick in the posterior-superior quadrant of the hip, beneath the gluteus minimus muscle [23]. Further, although the ischiofemoral ligament is the primary ligamentous restraint to internal rotation, Martin et al [11] showed that the superior band of Bigelow's ligament provides additional stability to the hip joint in both internal and external rotation.…”

Section: Discussionmentioning

confidence: 99%

“…The iliofemoral ligament is primarily an anterior structure, but Walters et al [23] demonstrated that its superior band expands superiorly and laterally. This band contributes to the hip capsule, where it is most thick in the posterior-superior quadrant of the hip, beneath the gluteus minimus muscle [23].…”

Section: Discussionmentioning

confidence: 99%

“…The plane between the gluteus minimus muscle and the superior capsule is developed with a periosteal elevator prior to capsulotomy, elevating the muscle from deep to its insertion on the femur to the acetabular margin. The proximal limb of the posterior capsulotomy is made deep to the gluteus minimus muscle and parallel to its posterior border, through the thickest portion of the capsule that corresponds to the superior band of Bigelow's ligament [23]. The capsulotomy is carried distally, releasing it along its lateral insertion along the distal femoral neck.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The proximal capsulotomy divides the thickest portion of the hip capsule [23], which lies deep to the gluteus minimus muscle and which includes the superior band of Bigelow's (iliofemoral) ligment [11,23]. This portion of the ligament contributes to hip stability in both internal and external rotation [11,23]. Further, magnetic resonance imaging has shown that dehiscense of the posterior capsular repair most frequently occurs proximally [17].…”

Section: Introductionmentioning

confidence: 99%

“…In this position, the prosthetic head dislocates posteriorly and superiorly, into the interval created by the proximal limb of the capsulotomy. The proximal capsulotomy divides the thickest portion of the hip capsule [23], which lies deep to the gluteus minimus muscle and which includes the superior band of Bigelow's (iliofemoral) ligment [11,23]. This portion of the ligament contributes to hip stability in both internal and external rotation [11,23].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Direct Repair of the Superior Band of Bigelow’s Ligament After Hip Arthroplasty: a Surgical Technique

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Direct Repair of the Superior Band of Bigelow’s Ligament After Hip Arthroplasty: a Surgical Technique

et al. 2016

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Retracted: Anatomy of the hip capsule and pericapsular structures: A cadaveric study

2015

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The anatomical literature contains relatively little qualitative or quantitative information regarding the anatomy of the hip joint capsule and its relationship to the surrounding pericapsular structures. We aimed to provide a detailed description of the anatomy of these relationships in a cadaveric study. Dissections of 11 nonpaired, fresh-frozen cadaveric hips were performed, documenting capsular dimensions and attachments to pericapsular structures including the rectus femoris, gluteus minimus, iliocapsularis, and piriformis and short external rotator muscles. Tendon footprints of these pericapsular muscles were measured, as well as their distance from reproducible bony landmarks. The thickest portion of the hip capsule is posterosuperiorly and superiorly near its acetabular origin, while the thinnest portion is posteriorly and posteroinferiorly near its femoral insertion. The piriformis has no capsular contribution; however, the reflected head of the rectus femoris, gluteus minimus, iliocapsularis, and external rotator tendons all demonstrate consistent capsular adhesions. There are complex associations among these structures, yet the surrounding layers of the capsule are confluent in predictable relationships. Knowledge of the intricate relationship between the hip capsule and pericapsular structures presented here will be useful for surgeons as they perform the precise and specific capsular releases required by various operative procedures. This study also provides information that can lead to further biomechanical, radiographic, and clinical studies on these structures.

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Dynamic changes of the joint capsule in relation to the zona orbicularis: An anatomical study with possible implications for hip stability mechanism

Tsutsumi

Nimura

Utsunomiya³

et al. 2021

Clinical Anatomy

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The zona orbicularis, which comprises the inner circular fibers of the joint capsule, is vital for hip stability in distraction. Despite the proximity of the whole joint capsule to the zona orbicularis, their anatomical relationship remains unclear. The aim of this study is to investigate the characteristics of the inner side of the joint capsule comprehensively. Twelve hips from nine bodies donated to science were examined. Six and three of the donated bodies, respectively, were embalmed using 8% formalin and Thiel's method. The joint capsules in three formalin-embalmed bodies were sturied by micro-computed tomography. During formalin fixation of six hips from these three bodies, one side was maintained at hip extension and the other at flexion. The remaining three formalin-embalmed bodies were examined histologically. Microcomputed tomography images revealed that the inward protrusion of the joint capsule narrowed the articular cavity, and the ratio of its narrowest area to that of the femoral neck was less at hip extension than at hip flexion. The Thiel's method specimens showed that the inner surface of the joint capsule protruded inward toward the femoral neck during hip extension. This inward protrusion was not histologically independent of the joint capsule. The zona orbicularis was interpreted as the inward protrusion caused by dynamic change of the joint capsule, rather than the local collar.In other words, the joint capsule could change its morphology dynamically depending on the hip position.

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New Findings in Hip Capsular Anatomy: Dimensions of Capsular Thickness and Pericapsular Contributions

Cited by 74 publications

References 26 publications

Direct Repair of the Superior Band of Bigelow’s Ligament After Hip Arthroplasty: a Surgical Technique

Direct Repair of the Superior Band of Bigelow’s Ligament After Hip Arthroplasty: a Surgical Technique

Retracted: Anatomy of the hip capsule and pericapsular structures: A cadaveric study

Dynamic changes of the joint capsule in relation to the zona orbicularis: An anatomical study with possible implications for hip stability mechanism

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