Gómez-Hoyos Juan, Márquez William H, Gallo Jaime A, Khoury Antony, Bernal-Sierra Sofía, Martin Hal D
Hip Preservation Center, Baylor Scott and White Research Institute, Dallas, Texas, U.S.A.
Orthopaedic Unit, Clínica del Campestre/Clínica Las Américas, Antioquia, Colombia.
Arthrosc Sports Med Rehabil. 2020 Dec 24;3(2):e297-e303. doi: 10.1016/j.asmr.2020.09.017. eCollection 2021 Apr.
To calculate the iliopsoas muscle/tendon ratio at 3 levels of arthroscopic iliopsoas tenotomy sites in fresh cadaveric specimens.
An anatomic study design was performed using 16 iliopsoas musculotendinous units from the level of the hip joint to their insertion on the lesser trochanter. All specimens came from 16 fresh cadaveric specimens (10 male, 6 female), with a median age of 41 years (range 31-55.25 years). Circumferential measurements of the composite musculotendinous unit and the iliopsoas tendon were then made at the lesser trochanter insertion, the site of transcapsular tenotomy, and the site of tenotomy at the level of the labrum. Anatomical variance of the iliopsoas tendon at the insertion on the lesser trochanter and muscular extension below the lesser trochanter level also were described. The difference between the median circumference of the iliopsoas musculotendinous units or the isolated tendons at the 3 levels was calculated.
The median circumference of the iliopsoas musculotendinous unit at the level of the labrum, orbicularis zone (transcapsular tenotomy site), and the lesser trochanter was 140.9 mm (range 137.9-148.9), 136.7 mm (range 132.9-140), and 99.5 mm (range 96.5-104.8), respectively. The median circumference of the iliopsoas tendon at these same levels was 25.6 mm (range 22.7-33.7), 28.9 mm (range 25.1-32.2), and 30.9 mm (range 27.9-36.1), respectively. Accordingly, the proportions of the iliopsoas muscle/tendon at the level of the labrum, the transcapsular tenotomy site, and the lesser trochanter insertion were 18% tendon/82% muscle, 21% tendon/79% muscle, and 31% tendon/69% muscle, respectively.
The proportions of the iliopsoas muscle/tendon at the level of the labrum, the transcapsular tenotomy site and the lesser trochanter insertion were 18% tendon/82% muscle, 21% tendon/79% muscle, and 31% tendon/69% muscle, respectively. The distal muscular projection below the tendinous insertion on the lesser trochanter may maintain the functional connection of the iliopsoas between origin and insertion even after releasing the tendon.
This finding may have implications for a new understanding of arthroscopic tenotomy of the iliopsoas around the hip, as previously described muscle/tendon proportions were not calculated in fresh cadavers.
计算新鲜尸体标本中关节镜下髂腰肌肌腱切断部位3个水平处的髂腰肌肌肉/肌腱比例。
采用解剖学研究设计，使用16个从髋关节水平至小转子附着处的髂腰肌肌腱单位。所有标本均来自16具新鲜尸体标本（10例男性，6例女性），中位年龄41岁（范围31 - 55.25岁）。然后在小转子附着处、经关节囊肌腱切断部位以及髋臼唇水平的肌腱切断部位对复合肌肉肌腱单位和髂腰肌肌腱进行周径测量。还描述了小转子附着处髂腰肌肌腱的解剖变异以及小转子水平以下的肌肉延伸情况。计算3个水平处髂腰肌肌肉肌腱单位或单独肌腱的中位周径差异。
髋臼唇水平、环形区域（经关节囊肌腱切断部位）和小转子处髂腰肌肌肉肌腱单位的中位周径分别为140.9毫米（范围137.9 - 148.9）、136.7毫米（范围132.9 - 140）和99.5毫米（范围96.5 - 104.8）。相同水平处髂腰肌肌腱的中位周径分别为25.6毫米（范围22.7 - 33.7）、28.9毫米（范围25.1 - 32.2）和30.9毫米（范围27.9 - 36.1）。因此，髋臼唇水平、经关节囊肌腱切断部位和小转子附着处的髂腰肌肌肉/肌腱比例分别为18%肌腱/82%肌肉、21%肌腱/79%肌肉和31%肌腱/69%肌肉。
髋臼唇水平、经关节囊肌腱切断部位和小转子附着处的髂腰肌肌肉/肌腱比例分别为18%肌腱/82%肌肉、21%肌腱/79%肌肉和31%肌腱/69%肌肉。小转子肌腱附着点以下的远端肌肉延伸即使在肌腱松解后也可能维持髂腰肌起止点之间的功能连接。
这一发现可能有助于对髋关节周围髂腰肌关节镜下肌腱切断术有新的认识，因为此前未在新鲜尸体中计算过上述肌肉/肌腱比例。
