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Bernese periacetabular osteotomy
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
The fascia over the tensor fasciae latae muscle is incised along the muscle fiber 1 cm lateral to the interval between sartorius and tensor. Blunt separation of the sartorius and tensor is done under the fascia. The hip was positioned into about 40° flexion. The sartorius and medial part of the fascia over the tensor fasciae latae muscle as well as the lateral femoral cutaneous nerve in the fasciae are reflected medially. Meanwhile, the tensor fasciae latae muscle is reflected laterally. This dissection is extended into the deep layer to expose the tendon of the rectus femoris. Medial to the rectus, the hypertrophic iliocapsularis muscle lies on the anterior articular capsule. The iliocapsularis muscle is dissected from the capsule and reflected medially.
Total Hip in a Day: Setup and Early Experiences in Outpatient Hip Surgery
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
This means that the hip joint is approached from the intermuscular spaces between the M. tensor fasciae latae muscle and the sartorius or rectus muscle. No muscles, tendons or ligaments are dissected! After clamping or ligating the femoral circumflex artery, the hip joint can be exposed from the front with very little bleeding. Following preparation of the acetabulum, the hip joint replacement is performed. On the basis of the corresponding preoperative planning and trial positioning, the final hip endoprosthesis is implanted and its position checked (Fig. 18.8).
The Gallbladder (GB)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Tensor fasciae latae muscle: Acts on the thigh to abduct, medially rotate, and flex it. Helps keep the knee extended and steadies the pelvis on the femur. Mainly serves to control movement of the hip by assisting the gluteus medius and minimus muscles in stabilizing the pelvis onto the femur bones.
Hip physical examination extension loss and radiographic osseous findings in patients with low back pain and nonarthritic hips
Published in Baylor University Medical Center Proceedings, 2022
Richard Feng, Munif Hatem, Scott J. Nimmons, Ashley Disantis, RobRoy L. Martin, Hal David Martin
In a cadaveric study by Morris et al, increased femoral torsion and acetabular version resulted in premature contact between the femoral neck and acetabulum.10 However, increased acetabular version does not imply posterior acetabular overcoverage, especially in hips with a lateralized femoral head. Therefore, the relationship between the posterior acetabular wall and center of the femoral head was utilized in the present study as a more logical contributor than acetabular version to limited HE. A limitation in the aforementioned cadaveric study was the inclusion of specimens without ligamentous or musculotendinous structures.10 The absence of an obvious osseous etiology in 35 (38%) hips with HE in our study indicates the fundamental role of musculotendinous and ligamentous structures in limiting HE. Tightness of the musculotendinous structures such as the iliopsoas, sartorius, rectus femoris, or tensor fascia lata muscle should be considered in patients with limited HE.4–6 The rectus femoris, sartorius, and tensor fascia lata muscles cross both the hip and knee joint, and the degree of knee flexion should be controlled during hip physical examination and assessment of HE. Increased terminal HE by extending the knee may indicate a contribution of one of the aforementioned musculotendinous structures in limiting HE. Long-lasting limited HE due to osseus etiologies may also lead to the subsequent tightening of anterior ligamentous and musculotendinous structures.
Anatomical course of the lateral femoral cutaneous nerve with special reference to the direct anterior approach to total hip arthroplasty
Published in Modern Rheumatology, 2020
Masahiko Sugano, Junichi Nakamura, Shigeo Hagiwara, Takane Suzuki, Takayuki Nakajima, Sumihisa Orita, Tsutomu Akazawa, Yawara Eguchi, Yohei Kawasaki, Seiji Ohtori
Safe zone and danger zone would be changed by different surgical approach. This study focuses on the DAA to THA, which is attracting attention as new technique. Rudin et al. [10] suggested that all of the fan type and proximal extension of the posterior type were in danger of LFCN injury. The current study defined the skin incision as 3 cm proximal to the tip of greater trochanter and 9 cm distal to the trochanter along the midline of the tensor fasciae latae muscle (12 cm in total) and regarded the intersection of the skin incision and nerve branch as LFCN injury. As a result, none (0%) of the anterior branches of the LFCN crossed over the skin incision, indicating all the anterior type were safe. By contrast, 68% of the posterior type crossed the line. In total, 27 of 64 thighs (42%) were at risk of the LFCN injury during DAA in THA. These messages are so practical and clinically significant to rheumatologist.