Ito Hiroshi, Song Yongnam, Lindsey Derek P, Safran Marc R, Giori Nicholas J
Department of Orthopaedic Surgery, Asahikawa Medical College, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan.
J Orthop Res. 2009 Aug;27(8):989-95. doi: 10.1002/jor.20852.
The structure and function of the proximal hip joint capsule and the zona orbicularis are poorly understood. We hypothesized that the zona orbicularis is an important contributor to hip stability in distraction. In seven cadaveric hip specimens from seven male donors we distracted the femur from the acetabulum in a direction parallel to the femoral shaft with the hip in the neutral position. Eight sequential conditions were assessed: (1) intact specimen (muscle and skin removed), (2) capsule vented, (3) incised iliofemoral ligament, (4) circumferentially incised capsule, (5) partially resected capsule (distal to the zona orbicularis), (6) completely resected capsule, (7) radially incised labrum, and (8) completely resected labrum. The reduction of the distraction load was greatest between the partially resected capsule phase and completely resected capsule phase at 1, 3, and 5 mm joint distraction (p = 0.018). The proximal to middle part of the capsule, which includes the zona orbicularis, appears grossly and biomechanically to act as a locking ring wrapping around the neck of the femur and is a key structure for hip stability in distraction.
近端髋关节囊和轮匝带的结构与功能尚未得到充分了解。我们推测轮匝带是髋关节在牵引时稳定性的重要贡献因素。在来自7名男性供体的7个尸体髋关节标本中，我们将髋关节置于中立位，沿平行于股骨干的方向将股骨从髋臼中牵开。评估了8个连续的状态：(1)完整标本（肌肉和皮肤已去除），(2)关节囊开孔，(3)切开髂股韧带，(4)环形切开关节囊，(5)部分切除关节囊（在轮匝带远端），(6)完全切除关节囊，(7)放射状切开盂唇，(8)完全切除盂唇。在关节牵引1、3和5毫米时，部分切除关节囊阶段和完全切除关节囊阶段之间的牵引负荷降低最为显著（p = 0.018）。关节囊的近端至中部，包括轮匝带，在大体和生物力学上似乎起到围绕股骨颈的锁环作用，并且是髋关节在牵引时稳定性的关键结构。
