title: The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres : an experimental study.
abstract: In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty.
authors.affiliation: Imperial College London, London SW7 2AZ, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: van Arkel
authors.affiliation: Imperial College London, London SW7 2AZ, UK.
authors.forename: A A
authors.initials: AA
authors.lastname: Amis
authors.affiliation: Charing Cross Hospital, London W6 8RF, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Cobb
authors.affiliation: Imperial College London, London SW7 2AZ, UK.
authors.forename: J R T
authors.initials: JR
authors.lastname: Jeffers
mesh_terms: D000077:Acetabulum / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002358:Cartilage, Articular / Q000502:physiology; D005260:Female; D051445:Fibrocartilage / Q000502:physiology; D006615:Hip / Q000502:physiology*; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D008023:Ligaments, Articular / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012399:Rotation; D019415:Torque
keywords: capsule; hip; labrum; ligamentum teres; primary restraints
references.citation: Arthroscopy. 2014 Oct;30(10):1380-2
references.pmid: 24951135
references.citation: J Biomech. 2003 Apr;36(4):577-91
references.pmid: 12600348
references.citation: J Orthop Res. 2013 Aug;31(8):1172-9
references.pmid: 23575923
references.citation: J Bone Joint Surg Br. 2008 Sep;90(9):1158-63
references.pmid: 18757954
references.citation: Am J Sports Med. 2011 Jul;39 Suppl:85S-91S
references.pmid: 21709037
references.citation: Knee Surg Sports Traumatol Arthrosc. 2012 Jun;20(6):1209-14
references.pmid: 21932079
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1664-8
references.pmid: 22885673
references.citation: Bone Joint Res. 2012 Mar 01;1(3):25-30
references.pmid: 23610667
references.citation: Am J Sports Med. 2011 Mar;39(3):557-66
references.pmid: 21160017
references.citation: Bone Joint J. 2013 Mar;95-B(3):314-9
references.pmid: 23450013
references.citation: Hip Int. 2012 May-Jun;22(3):329-34
references.pmid: 22740276
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1689-93
references.pmid: 23117165
references.citation: J Biomech. 2001 Jul;34(7):859-71
references.pmid: 11410170
references.citation: Am J Sports Med. 2003 Nov-Dec;31(6):1020-37
references.pmid: 14623676
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Apr;22(4):902-5
references.pmid: 23851921
references.citation: Clin Orthop Relat Res. 2006 Jun;447:34-8
references.pmid: 16741471
references.citation: Am J Sports Med. 2007 Nov;35(11):1918-21
references.pmid: 17703000
references.citation: Bone Joint J. 2013 Jan;95-B(1):10-9
references.pmid: 23307667
references.citation: Am J Anat. 1991 Sep;192(1):1-13
references.pmid: 1750378
references.citation: Arthroscopy. 2012 Mar;28(3):440-5
references.pmid: 22301357
references.citation: J Bone Joint Surg Am. 2009 Jan;91(1):192-7
references.pmid: 19122095
references.citation: Bone Joint J. 2014 Jan;96-B(1):5-18
references.pmid: 24395304
references.citation: J Bone Joint Surg Br. 1991 Mar;73(2):260-7
references.pmid: 2005151
references.citation: Arthroscopy. 2011 Dec;27(12):1720-31
references.pmid: 22047925
references.citation: Singapore Med J. 1990 Aug;31(4):360-3
references.pmid: 2124003
references.citation: Arthroscopy. 2013 Jan;29(1):162-73
references.pmid: 22901333
references.citation: Arthroscopy. 2009 Apr;25(4):405-7
references.pmid: 19341928
references.citation: Arthroscopy. 2009 Apr;25(4):400-4
references.pmid: 19341927
references.citation: J Bone Joint Surg Br. 2012 Jul;94(7):901-7
references.pmid: 22733943
references.citation: Knee Surg Sports Traumatol Arthrosc. 1995;3(1):9-13
references.pmid: 7773824
references.citation: Clin Orthop Relat Res. 2009 Mar;467(3):760-8
references.pmid: 19018604
references.citation: Arthroscopy. 2012 Jun;28(6):860-71
references.pmid: 22365268
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Feb;21(2):420-3
references.pmid: 23179452
references.citation: Arthroscopy. 2008 Feb;24(2):188-95
references.pmid: 18237703
references.citation: J Biomech. 2002 Apr;35(4):543-8
references.pmid: 11934426
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1655-63
references.pmid: 22752414