Related Papers
Bone Joint J
Surgical anatomy of the piriformis tendon, with particular reference to total hip replacement. A cadaver study
2013 •
Riaz Khan
The piriformis muscle is an important landmark in the surgical anatomy of the hip, particularly the posterior approach for total hip replacement (THR). Standard orthopaedic teaching dictates that the tendon must be cut in to allow adequate access to the superior part of the acetabulum and the femoral medullary canal. However, in our experience a routine THR can be performed through a posterior approach without sacrificing this tendon. We dissected the proximal femora of 15 cadavers in order to clarify the morphological anatomy of the piriformis tendon. We confirmed that the tendon attaches on the crest of the greater trochanter, in a position superior to the trochanteric fossa, away from the entry point for broaching the intramedullary canal during THR. The tendon attachment site encompassed the summit and medial aspect of the greater trochanter as well as a variable attachment to the fibrous capsule of the hip joint. In addition we dissected seven cadavers resecting all posterior attachments except the piriformis muscle and tendon in order to study their relations to the hip joint, as the joint was flexed. At flexion of 90° the piriformis muscle lay directly posterior to the hip joint. The piriform fossa is a term used by orthopaedic surgeons to refer the trochanteric fossa and normally has no relation to the attachment site of the piriformis tendon. In hip flexion the piriformis lies directly behind the hip joint and might reasonably be considered to contribute to the stability of the joint. We conclude that the anatomy of the piriformis muscle is often inaccurately described in the current surgical literature and terms are used and interchanged inappropriately.
Mohamed Elalfy
Introduction: Hip joint is matchless developmentally, anatomically and physiologically. It avails both mobility and stability. As the structural linkage between the axial skeleton and lower limbs, it plays a pivotal role in transmitting forces from the ground up and carrying forces from the trunk, head, neck and upper limbs down. This Article reviews the embryology, anatomy and biomechanics of the hip to give a hand in diagnosis, evaluation and treatment of hip disorders. Discussion: Exact knowledge about development, anatomy and biomechanics of hip joint has been a topic of interest and debate in literature dating back to at least middle of 18 th century, as Hip joint is liable for several number of pediatric and adult disorders. The proper acting of the hip counts on the normal development and congruence of the articular surfaces of the femoral head (ball) and the acetabulum (socket). It withstands enormous loads from muscular, gravitational and joint reaction forces inherent in weight bearing. Conclusion: The clinician must be familiar with the normal embryological, anatomical and biomechanical features of the hip joint. For early diagnosis, evaluation and proper treatment of hip disorders.
Journal of Orthopaedic Trauma
Is There a Gluteus Medius Tendon Injury During Reaming Through a Modified Medial Trochanteric Portal? A Cadaver Study
2007 •
Eddy Perez
Biomedical Journal of Scientific & Technical Research
Hip Joint: Embryology, Anatomy and Biomechanics
2018 •
Mohamed Elalfy
Journal of hip preservation surgery
Surgical hip dislocation does not result in atrophy or fatty infiltration of periarticular hip muscles
2014 •
Moritz Tannast
Surgical hip dislocation is the gold standard for treatment of femoroacetabular impingement (FAI). It utilizes an intermuscular and internervous approach to the hip. Concerns have been expressed that this approach causes soft tissue trauma resulting in post-operative muscle weakness of patients undergoing this procedure. We therefore asked whether surgical hip dislocation leads to (i) atrophy (decreased muscle diameter or cross-sectional area [CSA]) and (ii) degeneration (fatty infiltration) of 18 evaluated periarticular hip muscles. We retrospectively evaluated 32 patients (34 hips) following surgical hip dislocation for the treatment of FAI using pre and post-operative magnetic resonance (MR) arthrography of the hip. We evaluated muscle diameter, CSA and degree of fatty infiltration according to Goutallier for 18 periarticular hip muscles on axial and sagittal views. The mean interval between pre and post-operative MR was 1.9 ± 1.5 years (range, 0.4-6.1 years). Pre and post-operat...
Orthopaedic journal of sports medicine
Surgically Relevant Bony and Soft Tissue Anatomy of the Proximal Femur
2014 •
Robert F . LaPrade
Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. Descriptive laboratory study. Fourteen cadaveric hemipelvises were dissected. A coordinate measuring device measured dimensions and interrelationships of the gluteal muscles, hip external rotators, pectineus, iliopsoas, and joint capsule in reference to osseous landmarks. The vastus tubercle, superomedial border of the greater trochanter, and femoral head-neck junction were distinct and reliable osseous landmarks. The anteroinferior tip of the vastus tubercle was 17.1 mm (95% CI: 14.5, 19.8 mm) anteroinferior to the center of the gluteus medius lateral insertional footprint and was 22.9 mm (95% CI: 20.1, 25.7 mm) inferolateral to...
Journal of Bone and Joint Surgery - British Volume
Anatomy of piriformis, obturator internus and obturator externus: IMPLICATIONS FOR THE POSTERIOR SURGICAL APPROACH TO THE HIP
2010 •
Lucian B Solomon
Posterior Hip Disorders
Gross and Endoscopic Posterior Hip Anatomy
2018 •
luis cerezal
International Journal of Orthopaedics Sciences
Trochanteric entry VS piriformis entry in case of antegrade nailing of femoral shaft fracture treatment: A prospective randomised comparative study
2019 •
Dr.SANJAY BHARTI
JBJS Essential Surgical Techniques
Surgical Hip Dislocation for Exposure of the Posterior Column
2019 •
Marius Keel
Background: Surgical hip dislocation is performed for safe and efficient management of acetabular fractures predominantly involving the posterior column. The dislocation of the femoral head allows for direct visualization of the hip joint during fracture treatment. Description: The patient is placed in the lateral decubitus position with sterile preparation and draping of the ipsilateral leg to allow for dislocation. The skin incision is straight and centered over the greater trochanter. After the skin incision, the interval between the gluteus maximus and medius muscles is developed. The sciatic nerve is identified, and special attention to the course of the medial circumflex femoral artery is given during dissection of the piriformis and triceps coxae muscles (obturator internus and superior and inferior gemelli muscles). The latter are incised 2 cm posterior to their insertion on the posterior aspect of the greater trochanter. The vastus lateralis muscle belly is elevated from th...
