Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, Ha-Refu'a St 7, 7747629, Ashdod, Israel.
Montefiore Department of Orthopaedic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Forcheimer Building, Bronx, NY, 10461, USA.
Arch Orthop Trauma Surg. 2020 Jan;140(1):85-92. doi: 10.1007/s00402-019-03293-6. Epub 2019 Nov 16.
Acetabular labral tear is a common pathology. In some clinical situations, primary labral repair may not be possible and labral reconstruction is indicated.
Describe the anatomy of the indirect head of the rectus femoris (IHRF) tendon with clinical application in arthroscopic labral reconstruction surgery.
Twenty-six cadaver hips were dissected. Thirteen measurements, each with clinical relevance to arthroscopic labral reconstruction using an IHRF tendon graft were taken on each hip. All measurements were taken in triplicate. Mean values, standard deviations and intra-observer reliability were calculated.
The mean footprint of the direct head of the rectus femoris tendon was 10.6 mm × 19.6 mm. The width and thickness at the confluence of both heads were 10.9 mm and 6.9 mm, respectively. The mean total length of the footprint and "free portion" of the IHRF was 55.3 mm, the mean cranial to caudal footprint measured at the 12 o'clock, 1 o'clock, and 2 o'clock positions were 22.3 mm. The mean length of the Indirect Head footprint alone was 38.1 mm. The mean length of IHRF tendon suitable for grafting was 46.1 mm and the mean number of clock face sectors covered by this graft was 3.3 clock face sectors. Intra-observer reliability was ≥ 0.90 for all recorded measurements. The origin of the IHRF on the acetabulum fans out posteriorly, becoming thinner and wider as the origin travels posteriorly. The tendon footprint is firmly attached on the lateral wall of the ilium and becomes a free tendon overlying the acetabular bone as it travels anteriorly and distally towards its muscular attachment.
The IHRF tendon is in an ideal location for harvesting and contains the appropriate thickness, length and triangular architecture to serve as a safe and local graft source for acetabular labral reconstruction surgery.
髋臼唇撕裂是一种常见的疾病。在某些临床情况下，可能无法进行原发性唇修复，因此需要进行唇重建。
描述间接股直肌头（IHRF）肌腱的解剖结构，并将其应用于关节镜下唇重建手术。
对 26 具尸体髋关节进行解剖。对每侧髋关节进行 13 项测量，每项测量均与使用 IHRF 肌腱移植物进行关节镜下唇重建具有临床相关性。所有测量均重复三次。计算平均值、标准差和观察者内可靠性。
股直肌头直接肌腱的平均足迹为 10.6mm×19.6mm。两个头融合处的宽度和厚度分别为 10.9mm 和 6.9mm。IHRF 的足迹和“自由部分”的总长度平均为 55.3mm，在 12 点、1 点和 2 点位置测量的颅侧到尾侧足迹平均值为 22.3mm。单独的间接头足迹的平均长度为 38.1mm。适合移植物的 IHRF 肌腱的平均长度为 46.1mm，该移植物覆盖的时钟面扇区的平均数量为 3.3 个时钟面扇区。所有记录测量的观察者内可靠性均≥0.90。IHRF 在髋臼上的起点向后扩散，随着起点向后移动，变得越来越细和越来越宽。肌腱足迹牢固地附着在髂骨的外侧壁上，并在向前和向远侧移动至其肌肉附着处时成为覆盖髋臼骨的游离肌腱。
IHRF 肌腱是收获的理想位置，具有适当的厚度、长度和三角结构，可以作为髋臼唇重建手术的安全和局部移植物来源。
