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Transverse acetabular ligament

Kartik Shenoy, Amos Z Dai, Siddharth A Mahure, Daniel J Kaplan, Brian Capogna, Thomas Youm
The acetabular labrum and the transverse acetabular ligament form a continuous ring of tissue on the periphery of the acetabulum that provides a seal for the hip joint and increases the surface area to spread load distribution during weight-bearing. When a labral tear is suspected, the treatment algorithm always begins with conservative management, including physical therapy and nonsteroidal anti-inflammatory drugs. When conservative management fails, patients become candidates for arthroscopic labral repair...
December 2017: Arthroscopy Techniques
Soon Hyuck Lee, Woo Young Jang, Gi Won Choi, Young Keun Lee, Hae Woon Jung
PURPOSE: To investigate the arthroscopic pathoanatomy of the transverse acetabular ligament (TAL) and determine whether a TAL incision is necessary for the concentric reduction of developmental dysplasia of the hip (DDH) in infants and young children. METHODS: We retrospectively reviewed patients who underwent arthroscopic-assisted reduction for DDH between July 2008 and April 2016. The indications for this intervention included patients in whom closed reduction failed and those who did not require bone operations...
December 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
C Glorion
Surgical reduction of congenital hip dislocation is technically challenging. In our practice, surgical reduction is usually reserved for patients who have failed non-operative treatment, which is the first-line strategy. However, primary surgery may be indicated if the dislocation is diagnosed late and can be performed until 8 years of age. The reduction step is crucial. It starts with painstaking exposure of the capsule. Identifying the lower part of the acetabulum is the key to accurate repositioning of the epiphysis...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
K Studer, N Williams, P Studer, M Baker, A Glynn, B K Foster, P J Cundy
PURPOSE: Identification of anatomical structures that block -reduction in developmental dysplasia of the hip (DDH) is -important for the management of this challenging condition. Obstacles to reduction seen on arthrogram are well-known. However, despite the increasing use of MRI in the assessment of adequacy of reduction in DDH, the interpretation of MRI patho-anatomy is ill-defined with a lack of relevant literature to guide clinicians. METHOD: This is a retrospective analysis of the MRI of patients with DDH treated by closed reduction over a five-year period (between 2009 and 2014)...
October 1, 2017: Journal of Children's Orthopaedics
Mohammed Hatem Salal
OBJECTIVE: To assess the results of the use of transverse acetabular ligament (TAL) as an intraoperative indicator for acetabular cup anteversion alignment during total hip replacement. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: The Nursing Home Hospital in Baghdad Medical City Complex, Baghdad, Iraq, from October 2014 to June 2015. METHODOLOGY: Patients were operated through a posterolateral approach for primary total hip arthroplasty (THA) in which transverse acetabular ligament (TAL) was identified and used as indicator for cup anteversion...
October 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ümit Tuhanioğlu, Hakan Cicek, Hasan U Ogur, Firat Seyfettinoglu, Ahmet Kapukaya
INTRODUCTION: The goal in the treatment of developmental dysplasia of the hip (DDH) is to achieve a stable and concentric reduction and to create a congruent relationship between the femoral head and the acetabulum. This study discusses the causes of loss of reduction in DDH patients who had a concentrically reduced hip at the time of removal of the hip spica cast and cessation of brace use and who later appeared with hip redislocation after mobilisation and ambulation. In addition, the possible interventions in such cases are also discussed...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Liang Zhao, Hua Yan, Changsheng Yang, Daozhang Cai, Yijun Wang
BACKGROUND: Arthroscopic reduction has become increasingly popular as an alternative to open reduction for the treatment of developmental dysplasia of the hip (DDH). However, patient outcomes beyond one and a half years after surgery remain unclear. The purpose of this study is to report the medium-term outcomes of walking-age patients who received arthroscopic reduction after an unsuccessful closed reduction. This research was conducted as part of a retrospectively registered study. METHODS: We performed arthroscopic reduction in eight children with DDH after failed closed reduction between January 2010 and January 2012 and followed all cases for a minimum of 5 years...
September 21, 2017: Journal of Orthopaedic Surgery and Research
Huw L M Williams, Gavin E Bartlett, Mark R Norton, Rory G Middleton
INTRODUCTION: Incorrect acetabular component positioning during total hip arthroplasty (THA) may lead to dislocation, impingement, wear and revision. Surgeons commonly use the transverse acetabular ligament (TAL) as a landmark for acetabular component orientation. The posterior acetabular wall (PAW) is a structure easily viewed on plain radiography and its position can help guide acetabular component position. In this study, we examine the efficacy of preoperative radiographs in predicting cup position relative to the PAW...
September 7, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Ameer M Elbuluk, Paul Wojack, Nima Eftekhary, Jonathan M Vigdorchik
Appropriate placement of the acetabular cup is an important determinant of implant stability and longevity. Malposition of acetabular cups negatively influences prosthesis survival and leads to an increased dislocation rate. The objective of the study was to determine the role of 3-dimensional templating in obtaining accurate acetabular component placement in total hip arthroplasty. In this computed tomography-based study, the authors identified 93 patients who underwent primary total hip arthroplasty with computer-assisted navigation...
July 1, 2017: Orthopedics
Mohammed El Idrissi, Abdelhalim Elibrahimi, Mohammed Shimi, Abdelmajid Elmrini
OBJECTIVE: The aim of our study is to present the benefit of using the transvers acetabular ligament for intraoperative determination of the anteversion of acetabular component. METHODS: Twenty-one total hip arthroplasties were performed. The transverse acetabular ligament was identified and used as a guide to position the acetabular component. RESULTS: The mean anteversion angle was 16.9. None of the patients studied sustained a postoperative dislocation during this short follow-up period...
September 2016: Acta Ortopedica Brasileira
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...
January 2017: 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...
September 29, 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
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