Skip to main content
SpringerLink
Log in

Gross Anatomy

  • Chapter
  • First Online:
Operative Hip Arthroscopy

  • 2856 Accesses

Abstract

Anatomical knowledge of the joint characteristics and surrounding structures (anatomical constraints, capsular reinforcements, peritrochanteric space, etc.) is basic for the surgical team to achieve good results avoiding iatrogenic lesions.

The hip can be divided arthroscopically into three compartments that comprise different anatomical structures. The first compartment was the first described in hip arthroscopy to diagnose and treat the different pathologies that affect the hip joint, and today this space is commonly known as the central compartment. The central compartment comprises the acetabular fossa, the lunate cartilage, the ligamentum teres, and the articular area of the femoral head. The peripheral compartment includes the femoral neck, the outer acetabular rim, synovial membrane, and the capsule including its capsular reinforcements (i.e., orbicularis zone). The acetabular labrum acts as a separator between central and peripheral compartment.

The last compartment corresponds to the peritrochanteric compartment that lies between the iliotibial band and the proximal femur and gives us the possibility to reach the deep gluteal region. Thanks to the technical development, the knowledge of the surrounding anatomical structures (sciatic nerve, inferior gluteal nerve, etc.) to the peritrochanteric space is necessary.

A review of the different anatomical structures related with the hip arthroscopy has been performed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Birscher E. Die arthroendoskopie. Zbl Chir. 1921;48:1460–1.

    Google Scholar 

  2. Burman MS. Arthroscopy or the direct visualization of joints: an experimental cadaver study. J Bone Joint Surg. 1931;13:669–95.

    Google Scholar 

  3. Kim S-J, Choi N-H, Kim H-J. Operative hip arthroscopy. Clin Orthop. 1998;353:156–65.

    Article  PubMed  Google Scholar 

  4. Dvorak M, Duncan CP, Day B. Arthroscopic anatomy of the hip. Arthroscopy. 1990;6:264–73.

    Article  PubMed  CAS  Google Scholar 

  5. Dorfmann H, Boyer T. Hip arthroscopy utilizing the supine position. Arthroscopy. 1996;12:264–7.

    Article  PubMed  CAS  Google Scholar 

  6. Dorfmann H, Boyer T. Arthroscopy of the hip: 12 years of experience. Arthroscopy. 1999;15:67–72.

    PubMed  CAS  Google Scholar 

  7. Wiese M, Rubenthaler F. Early results of endoscopic trochanter bursectomy. Int Orthop. 2004;28:218–21.

    Article  PubMed  Google Scholar 

  8. Voos JE, Rudzki JR, Shindle MK, et al. Arthroscopic anatomy and surgical techniques for peritrochanteric space disorders in the hip. Arthroscopy. 2007;23:1246.e1–e5.

    Article  Google Scholar 

  9. Robertson WJ, Kelly BT. The safe zone for hip arthroscopy: a cadaveric assessment of central, peripheral, and lateral compartment portal placement. Arthroscopy. 2008;24:1019–26.

    Article  PubMed  Google Scholar 

  10. Ilizaliturri Jr VM, Martinez-Escalante FA, Chaidez PA, et al. Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy. 2006;22:505–10.

    Article  PubMed  Google Scholar 

  11. Cerezal L, Kassarjian A, Canga A, et al. Anatomy, biomechanics, imaging, and management of ligamentum teres injuries. Radiographics. 2010;30:1637–51.

    Article  PubMed  Google Scholar 

  12. Rao J, Zhou YX, Villar RN. Injury to the ligamentum teres: mechanism, findings, and results of treatment. Clin Sports Med. 2001;20:791–9.

    Article  PubMed  CAS  Google Scholar 

  13. Bardakos NV, Villar RN. The ligamentum teres of the adult hip. J Bone Joint Surg Br. 2009;91:8–15.

    PubMed  CAS  Google Scholar 

  14. Testut L, Latarjet A. Anatomía humana. 4th ed. Barcelona: Salvat editores SA; 1990. p. 660–76.

    Google Scholar 

  15. Chandler SB, Kreuscher PH. A study of the blood supply of the ligamentum teres and its relation to the circulation of the head of the femur. J Bone Joint Surg. 1932;14:834–46.

    Google Scholar 

  16. Lavigne M, Kalhor M, Beck M, et al. Distribution of vascular foramina around the femoral head and neck junction: relevance for conservative intracapsular procedures of the hip. Orthop Clin North Am. 2005;36:171–6.

    Article  PubMed  Google Scholar 

  17. Gautier E, Ganz K, Krugel N, et al. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000;82:679–83.

    Article  PubMed  CAS  Google Scholar 

  18. Carliouz H, Pous JG, Rey JC. Les epiphysiolyses femorales superrieures. Rev Chir Orthop Reparatice Appar Mot. 1968;54:388–481.

    Google Scholar 

  19. Kapandji AI. Fisiología articular. Miembro inferior. 5th ed. Buenos Aires: Editorial Médica Panamericana; 1998. p. 14–72.

    Google Scholar 

  20. Feugier P, Fessy MH, Bejui J, et al. Acetabular anatomy and the relationship with pelvic vascular structures. Surg Radiol Anat. 1997;19:85–90.

    Article  PubMed  CAS  Google Scholar 

  21. Fernández-Fairén M. Biomecánica de la cadera. In: Viladot A, editor. Lecciones básicas de biomecánica del aparato locomotor. 1st ed. Barcelona: Springer; 2001. p. 185–96.

    Google Scholar 

  22. Govsa F, Ozer MA, Ozgur Z. Morphologic features of the acetabulum. Arch Orthop Trauma Surg. 2005;125:453–61.

    Article  PubMed  Google Scholar 

  23. Gupta V, Choudhry R, Tuli A, et al. Unusual facets on the acetabulum in dry adult human coxal bones: a morphological and radiological study. Surg Radiol Anat. 2001;23:263–7.

    Article  PubMed  CAS  Google Scholar 

  24. Sampatchalit S, Barbosa D, Gentili A, et al. Degenerative changes in the ligamentum teres of the hip: cadaveric study with magnetic resonance arthrography, anatomical inspection, and histologic examination. J Comput Assist Tomogr. 2009;33:927–33.

    Article  PubMed  Google Scholar 

  25. Chen HH, Li AF, Li KC, et al. Adaptations of ligamentum teres in ischemic necrosis of human femoral head. Clin Orthop Relat Res. 1996;328:268–75.

    Article  PubMed  Google Scholar 

  26. Demange MK, Kakuda CM, Pereira CA, et al. Influence of the femoral head ligament on hip mechanical function. Acta Orthop Bras. 2007;15:187–90.

    Google Scholar 

  27. Leunig M, Beck M, Stauffer E, et al. Free nerve endings in the ligamentum capitis femoris. Acta Orthop Scand. 2000;71:452–4.

    Article  PubMed  CAS  Google Scholar 

  28. Gray AJ, Villar RN. The ligamentum teres of the hip: an arthroscopic classification of its pathology. Arthroscopy. 1997;13:575–8.

    Article  PubMed  CAS  Google Scholar 

  29. Lecouvet F, Vande Berg BC, Malghem J, et al. MR imaging of the acetabular labrum: variations in 200 asymptomatic hips. AJR. 1996;167:1025–8.

    PubMed  CAS  Google Scholar 

  30. Won Y-Y, Chung I-H, Chung N-S, et al. Morphological study on the acetabular labrum. Yonsei Med J. 2003;44:855–62.

    PubMed  Google Scholar 

  31. Ferguson SJ, Bryant JT, Ganz R, et al. The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model. J Biomech. 2000;33:953–60.

    Article  PubMed  CAS  Google Scholar 

  32. Ferguson SJ, Bryant JT, Ganz R, et al. The acetabular labrum seal: a poroelastic finite element model. Clin Biomech. 2000;15:463–8.

    Article  CAS  Google Scholar 

  33. Kalhor M, Beck M, Huff TW, et al. Capsular and pericapsular contributions to acetabular and femoral head perfusion. J Bone Joint Surg Am. 2009;91:409–18.

    Article  PubMed  Google Scholar 

  34. Beck M, Leunig M, Ellis T, et al. The acetabular blood supply: implications for periacetabular osteotomies. Surg Radiol Anat. 2003;25:361–7.

    Article  PubMed  CAS  Google Scholar 

  35. Martin HD, Savage A, Braly BA, et al. The function of the hip capsular ligaments: a quantitative report. Arthroscopy. 2008;24:188–95.

    Article  PubMed  Google Scholar 

  36. Hewitt JD, Glisson RR, Guilak F, et al. The mechanical properties of the human hip capsule ligaments. J Arthroplasty. 2002;17:82–9.

    Article  PubMed  Google Scholar 

  37. Fu Z, Peng M, Peng Q. Anatomical study of the synovial plicae of the hip joint. Clin Anat. 1997;10:235–8.

    Article  PubMed  CAS  Google Scholar 

  38. Dienst M, Gödde S, Seil R, et al. Hip arthroscopy without traction: in vivo anatomy of the peripheral hip joint cavity. Arthroscopy. 2001;17:924–31.

    Article  PubMed  CAS  Google Scholar 

  39. Beck M, Sledge JB, Gautier E, et al. The anatomy and function of the gluteus minimus muscle. J Bone Joint Surg Br. 2000;82:358–63.

    Article  PubMed  CAS  Google Scholar 

  40. Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179–89.

    PubMed  CAS  Google Scholar 

  41. Pfirrmann CWA, Chung CB, Theumann NH, et al. Greater trochanter of the hip. Attachment of the abductor mechanism and a complex of three bursae – MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology. 2001;221:469–77.

    Article  PubMed  CAS  Google Scholar 

  42. Bywaters EGL. The bursae of the body. Ann Rheum Dis. 1965;24:215–8.

    Article  PubMed  CAS  Google Scholar 

  43. Duparc F, Thomine JM, Dujardin F, et al. Anatomic basis of the transgluteal approach to the hip-joint by anterior hemimyotomy of the gluteus medius. Surg Radiol Anat. 1997;19:61–7.

    Article  PubMed  CAS  Google Scholar 

  44. Lavigne P, de Loriot Rouvray TH. The superior gluteal nerve. Anatomical study of its extrapelvic portion and surgical resolution by trans-gluteal approach. Rev Chir Orthop Reparatrice Appar Mot. 1994;80:188–95.

    PubMed  CAS  Google Scholar 

  45. Martin HD, Shears SA, Johnson JC, et al. The endoscopic treatment of sciatic nerve entrapment/deep gluteal syndrome. Arthroscopy. 2011;27:172–81.

    Article  PubMed  Google Scholar 

  46. Miller SL, Gill J, Webb GR. The proximal origin of the hamstrings and surrounding anatomy encountered during repair. A cadaveric study. J Bone Joint Surg Am. 2007;89:44–8.

    Article  PubMed  Google Scholar 

  47. Apaydin N, Bozkurt M, Loukas M, et al. The course of the inferior gluteal nerve and surgical landmarks for its localization during posterior approaches to hip. Surg Radiol Anat. 2009;31:415–8.

    Article  PubMed  Google Scholar 

  48. Ling ZX, Kumar VP. The course of the inferior gluteal nerve in the posterior approach to the hip. J Bone Joint Surg Br. 2006;88:1580–3.

    Article  PubMed  CAS  Google Scholar 

  49. Shu B, Safran MR. Bifid iliopsoas tendon causing refractory internal snapping hip. Clin Orthop Relat Res. 2011;469:289–93.

    Article  PubMed  Google Scholar 

  50. Deslandes M, Guillin R, Cardinal E, et al. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190:576–81.

    Article  PubMed  Google Scholar 

  51. Ilizaliturri VM, Villalobos FE, Chaidez PA, et al. Internal snapping hip syndrome: treatment by endoscopic release of the iliopsoas tendon. Arthroscopy. 2005;11:1375–80.

    Google Scholar 

  52. Tatu L, Parratte B, Vuillier F, et al. Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip. Surg Radiol Anat. 2001;23:371–4.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Transplant Services Foundation, Musculoskeletal Tissue Unit, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08031, Spain

    Oscar Fariñas Barberá M.D.

  2. Department of Human Anatomy and Embriology, Facultat de Medicina, C/Casanova 143, Barcelona, Spain

    Ivan Sáenz Navarro M.D.

Authors
  1. Oscar Fariñas Barberá M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ivan Sáenz Navarro M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oscar Fariñas Barberá M.D. .

Editor information

Editors and Affiliations

  1. Orthopaedic Center, Baptist Medical Plaza I, Nashville Sports Medicine and, Church Street 2011, Nashville, 37203, Tennessee, USA

    J.W. Thomas Byrd

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Barberá, O.F., Navarro, I.S. (2013). Gross Anatomy. In: Byrd, J. (eds) Operative Hip Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7925-4_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-7925-4_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-7924-7

  • Online ISBN: 978-1-4419-7925-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation