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Transverse acetabular ligament

George Grammatopoulos, Abtin Alvand, A Paul Monk, Stephen Mellon, Hemant Pandit, Jonathan Rees, Harinderjit S Gill, David W Murray
BACKGROUND: Wide variability in cup orientation has been reported. The aims of this study were to determine how accurate surgeons are at orientating the acetabular component and whether factors such as visual cues and the side of operating table improved accuracy. METHODS: A pelvic model was positioned in neutral alignment on an operating table and was prepared as in a posterior approach. Twenty-one surgeons (9 trainers and 12 trainees) were tasked with positioning an acetabular component in a series of target orientations...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Matthew J Harris, Jason Tam, Steven J Fineberg, Paul A Lucas, Steven B Zelicof
BACKGROUND: The transverse acetabular ligament (TAL) has been described as an anatomic landmark to guide in the positioning of the acetabular component during total hip arthroplasty. On plain films, the radiographic teardrop (RT) has similarly been used as a measure of appropriate cup positioning. The goal of this study is to quantify the distance and location between the anatomic TAL and RT landmarks to aid in the positioning of acetabular component. METHODS: Sixteen randomly selected cadaveric pelvises (eight males, eight females) underwent dissection...
July 15, 2016: Journal of Arthroplasty
Huaqiang Sun, Shufeng Li, Yeteng He, Teng Wang, Zhaolong Yu, Xinfeng Yan
BACKGROUND/OBJECTIVE: The transverse acetabular ligament (TAL) can be used to position the acetabular cup and may help to improve the accuracy of primary total hip arthroplasty (THA). However, because the TAL may be covered by osteophytes, the ability to find the TAL varies greatly in the reported literature. In the present study, we introduce 2 methods and make a comparison between them to identify the easier procedure for finding an osteophyte-covered TAL. METHODS: During primary THA operations conducted from January 2012 to June 2015, a total of 100 patients (100 hips) were confirmed to have an osteophyte-covered TAL following the exposure of the acetabulum and removal of all soft tissues covering the TAL...
May 30, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Willem B Hiddema, Johan F van der Merwe, Werner van der Merwe
BACKGROUND: The success of a total hip arthroplasty relies on optimal acetabular cup placement to ensure mating of the femoral head and acetabular cup throughout all positions of the hip joint. Poor cup placement is associated with dislocation, impingement, microseparation, component loosening, and accelerated wear due to rim loading. This study examined a novel method of using the transverse acetabular ligament (TAL) to guide cup inclination during primary total hip arthroplasty. METHODS: A descriptive study using 16 hips from 9 cadavers...
July 2016: Journal of Arthroplasty
D E Beverland, C K J O'Neill, M Rutherford, D Molloy, J C Hill
Ideal placement of the acetabular component remains elusive both in terms of defining and achieving a target. Our aim is to help restore original anatomy by using the transverse acetabular ligament (TAL) to control the height, depth and version of the component. In the normal hip the TAL and labrum extend beyond the equator of the femoral head and therefore, if the definitive acetabular component is positioned such that it is cradled by and just deep to the plane of the TAL and labrum and is no more than 4mm larger than the original femoral head, the centre of the hip should be restored...
January 2016: Bone & Joint Journal
Byung-Ho Yoon, Yong-Chan Ha, Young-Kyun Lee, Woo-Lam Jo, Kyoung-Min Lee, Kyung-Hoi Koo
BACKGROUND: Transverse acetabular ligament (TAL) has been used as a landmark for aligning cup anteversion. The use of TAL as a guide is based on the assumption that TAL version is distributed within the safe zone of acetabular cup. However, there was rarely reported to compare anteversion between TAL and acetabulum using direct measurement methods. The purpose of this study was to measure the anteversion of TAL in computed tomography arthrography (CTA) and compare it with Lewinnek's safe zone and anteversion of bony acetabulum...
March 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
W Andrew Lee, Adriana J Saroki, Sverre Løken, Christiano A C Trindade, Tyler R Cram, Broc R Schindler, Robert F LaPrade, Marc J Philippon
BACKGROUND: The anatomy of the acetabulum has been described extensively in the literature, but radiographic acetabular guidelines have not been well established. This study provides a radiographic map of acetabular landmarks in the hip. PURPOSE/HYPOTHESIS: The purpose of this study was to quantify the precise radiographic location of arthroscopic landmarks around the acetabulum. The hypothesis was that their locations were reproducible despite variability in the anatomy and positioning of pelvic specimens...
January 2016: American Journal of Sports Medicine
Vivek Perumal, Stephanie J Woodley, Helen D Nicholson
The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed...
March 2016: Clinical Anatomy
Yingxu Fu, Desheng Yang, Asihaerjiang-Maimaitiyiming, Li Cao, Wentao Guo
OBJECTIVE: To explore the method of acetabular orientation determination in total hip arthroplasty (THA) for bony ankylosed hip and the accuracy of the postoperative evaluation. METHODS: Between January 2009 and March 2013, 33 consecutive patients (49 hips) underwent THA. There were 25 males and 8 females with a mean age of 35.8 years (range, 18-69 years). The left hip was involved in 10 cases, the right hip in 7 cases, and bilateral hips in 16 cases. The causes were ankylosing spondylitis in 18 patients, tuberculosis in 6 patients, traumatic arthritis in 6 patients, osteoarthritis in 2 patients, and suppurative infection in 1 patient...
April 2015: Chinese Journal of Reparative and Reconstructive Surgery
Kevin J Rasuli, Wade Gofton
BACKGROUND: A new family of micro-posterior approaches, percutaneously assisted total hip (PATH), SuperCapsular (SuperCap) and Supercapsular percutaneously assisted total hip (SuperPATH) allow preservation of the short external rotators. This study assesses early outcomes and learning curves of the PATH and SuperPATH approaches. METHODS: Early outcomes of the first consecutive 49 PATH and 50 SuperPATH cases performed by a non-developer surgeon were evaluated. Analysis of variance (ANOVA) was used to compare age, body mass index (BMI), and pre-operative hemoglobin...
August 2015: Annals of Translational Medicine
Kasım Kılıçarslan, Aydan Kılıçarslan, İsmail Demirkale, Mahmut Nedim Aytekin, Mehmet Atıf Erol Aksekili, Mahmut Uğurlu
OBJECTIVE: The labrum and transverse acetabular ligament (TAL) are classically described as distinct anatomical structures with abundant mechanoreceptors and free nerve fibers. They deepen the joint and act as natural barriers against dislocation, thus providing additional stability. We hypothesized that severe coxarthrosis leads to elimination of labrum and TAL mechanoreceptors. This study evaluated the microscopic anatomy of the labrum and TAL and specifically investigated the neurological status of these structures...
2015: Acta Orthopaedica et Traumatologica Turcica
Oliver Eberhardt, Thomas Wirth, Francisco F Fernandez
PURPOSE: The purpose of this study was to describe the anatomy as seen arthroscopically, the role of the labrum and its relevance in luxation and reduction procedures, and secondary changes to the cartilaginous acetabular roof and to determine the main obstacles preventing reduction of dislocated hips in infants and young children. METHODS: A specialized pediatric medial approach to hip arthroscopy was performed on 25 hip joints in 21 patients younger than 4 years of age...
June 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Aline Suter, Tobias J Dietrich, Matthias Maier, Claudio Dora, Christian W A Pfirrmann
PURPOSE: To determine which MR-arthrography findings are associated with positive hip joint distraction. MATERIALS AND METHODS: One hundred patients with MR arthrography of the hip using axial traction were included. Traction was applied during the MR examination with an 8 kg (females) or 10 kg (males) water bag, attached to the ankle over a deflection pulley. Fifty patients showing joint space distraction were compared to an age- and gender-matched control group of 50 patients that did not show a joint distraction under axial traction...
June 2015: Skeletal Radiology
Marc J Philippon, Max P Michalski, Kevin J Campbell, Mary T Goldsmith, Brian M Devitt, Coen A Wijdicks, Robert F LaPrade
BACKGROUND: The clock face has been employed to define the position of labral pathology in relation to identifiable arthroscopically relevant acetabular landmarks. The purpose of this study was to qualitatively and quantitatively describe arthroscopically relevant anatomy of the acetabulum. We aimed to present a surgical landmark that is located in close proximity to the usual location of labral pathology as an alternative to the midpoint of the transverse acetabular ligament as a reference point...
October 15, 2014: Journal of Bone and Joint Surgery. American Volume
C Casteleyn, I den Ouden, F Coopman, G Verhoeven, S Van Cruchten, C Van Ginneken, B Van Ryssen, P Simoens
Numerous conventional anatomical textbooks describe the canine hip joint, but many contradictions, in particular regarding the ligament of the femoral head, are present. This paper presents a brief overview of the different literature descriptions. These are compared with own observations that have resulted in a revised description of the anatomy of the ligament of the femoral head in the dog. To this purpose, the hip joints of 41 dogs, euthanized for reasons not related to this study and devoid of lesions related to hip joint pathology, were examined...
December 2015: Anatomia, Histologia, Embryologia
V Kumar, S Sharma, J James, J P Hodgkinson, M V Hemmady
Despite a lack of long-term follow-up, there is an increasing trend towards using femoral heads of large diameter in total hip replacement (THR), partly because of the perceived advantage of lower rates of dislocation. However, increasing the size of the femoral head is not the only way to reduce the rate of dislocation; optimal alignment of the components and repair of the posterior capsule could achieve a similar effect. In this prospective study of 512 cemented unilateral THRs (Male:Female 230:282) performed between 2004 and 2011, we aimed to determine the rate of dislocation in patients who received a 22 mm head on a 9/10 Morse taper through a posterior approach with capsular repair and using the transverse acetabular ligament (TAL) as a guide for the alignment of the acetabular component...
September 2014: Bone & Joint Journal
Xiaodong Qin, Xiang Li, Tianrun Lü, Lijun Song, Ning Zhang, Weimin Fan
OBJECTIVE: To investigate the clinical results of modified subinguinal approach without iliac osteotomy for anterior surgical treatment of acetabular fractures which involve the anterior wall and medial wall or in combination with femoral neck fracture. METHODS: The subinguinal approach was modified after anatomical study on 12 adult cadavers. Between May 2010 and March 2012, 34 patients with acetabular fracture that involved the anterior wall and medial wall or in combination with femoral neck fracture were treated with open reduction and internal fixation through modified subinguinal approach in 15 cases and through modified subinguinal approach combined with Kocher-Langenbeck approach...
January 2014: Chinese Journal of Reparative and Reconstructive Surgery
Osama Farouk, Ayman Kamal, Mahmoud Badran, Wael El-Adly, Kamal El-Gafary
INTRODUCTION: Minimal invasive fixation has been reported as an alternative option for treatment of acetabular fractures to avoid blood loss and complications of extensive approaches. Closed reduction and percutaneous lag screw fixation can be done in minimally displaced acetabular fractures. Open reduction is indicated, if there is wide displacement. In this study, we report the use of a mini-open anterior approach to manipulate and reduce anteriorly displaced transverse acetabular fractures combined with percutaneous lag screw fixation...
June 2014: Injury
G Meermans, W J Van Doorn, K Koenraadt, J Kats
The orientation of the acetabular component can influence both the short- and long-term outcomes of total hip replacement (THR). We performed a prospective, randomised, controlled trial of two groups, comprising of 40 patients each, in order to compare freehand introduction of the component with introduction using the transverse acetabular ligament (TAL) as a reference for anteversion. Anteversion and inclination were measured on pelvic radiographs. With respect to anteversion, in the freehand group 22.5% of the components were outside the safe zone versus 0% in the transverse acetabular ligament group (p = 0...
March 2014: Bone & Joint Journal
K Fujita, T Kabata, T Maeda, Y Kajino, S Iwai, K Kuroda, K Hasegawa, H Tsuchiya
It has recently been reported that the transverse acetabular ligament (TAL) is helpful in determining the position of the acetabular component in total hip replacement (THR). In this study we used a computer-assisted navigation system to determine whether the TAL is useful as a landmark in THR. The study was carried out in 121 consecutive patients undergoing primary THR (134 hips), including 67 dysplastic hips (50%). There were 26 men (29 hips) and 95 women (105 hips) with a mean age of 60.2 years (17 to 82) at the time of operation...
March 2014: Bone & Joint Journal
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