Bernese periacetabular osteotomy
K. Mohan Iyer in 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.
The Articulations of the Lower Member
Gene L. Colborn, David B. Lause in Musculoskeletal Anatomy, 2009
Second, the sartorius arises from the anterior superior iliac spine and crosses the length of the thigh obliquely, from anterior to medial before inserting upon the tibia. Third, the rectus femoris has two rather distinct sites of origin from the hip bone. The more obvious origin is the anterior inferior iliac spine. Posteriorly, a second tendon arises just above the acetabulum and travels forward to join the tendon arising from the anterior inferior iliac spine. The combined rectus tendon joins the other tendons of the quadriceps femoris distally in the anterior compartment of the thigh. Finally, the tensor fasciae latae muscle arises from the lateral and anterior portion of the iliac crest. Its tendinous fibers join those of the gluteus maximus which insert by means of the iliotibial tract on the lateral aspect of the tibia, proximally.
Total Hip in a Day: Setup and Early Experiences in Outpatient Hip Surgery
K. Mohan Iyer in 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).
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.
Related Knowledge Centers
- Anterior Superior Iliac Spine
- Iliac Crest
- Muscle
- Sartorius Muscle
- Thigh
- Tibia
- Pelvis
- Gluteus Maximus
- Iliotibial Tract
- Gluteus Medius