Benes Michal, Bartak Vladislav, Uhlik Jiri, Novotny Tomas, Rybakova Aneta, Kachlik David, Kunc Vojtech
Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Center for Endoscopic, Surgical and Clinical Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Anat Cell Biol. 2025 Jun 30;58(2):155-165. doi: 10.5115/acb.24.329. Epub 2025 Apr 8.
This study aimed to delineate the macroscopic and microscopic topography of muscles surrounding the anterior aspect of the hip joint and the underlaying joint capsule. Seven fresh-frozen cadavers were bilaterally dissected as per study protocol. Eleven hip joints were evaluated macroscopically, while three hip joints underwent histological analysis. Additionally, twenty hip bones and femurs were examined for the osseous morphology near the anterior portion of the articulating surfaces. Macroscopically, the rectus femoris muscle contributed to the articular capsule exclusively through its reflected head. The iliocapsularis and iliopsoas muscles were in direct contact with the articular capsule. Although the iliocapsularis muscle was adherent to the capsule throughout its whole course, the iliopsoas muscle was connected to the capsule through the iliopectineal bursa. Microscopically, different spatial thickness of the capsule was observed, with the thicker regions corresponding to the capsular ligaments. Osseous landmarks, relevant to the course of the iliopsoas muscle, included the iliopsoas notch and a groove for the psoas major muscle. Furthermore, split of the anterior inferior iliac spine and the "subspine" were constant findings corresponding to the origin of the direct head of the rectus femoris and the iliocapsularis muscles, and attachment of the medial band of the iliofemoral ligament, respectively. On the head of the femur, the Poirier's facet (35.0%), the Allen's fossa (60.0%), and the so-called plaque (50.0%) were observed. Conclusively, we introduce the concept of a four-layered anterior musculocapsular complex of the hip, aiming to aid the orthopaedic surgeon in both hip replacement and preservation procedures.
本研究旨在描绘髋关节前方周围肌肉及下方关节囊的宏观和微观形态。按照研究方案对7具新鲜冷冻尸体进行双侧解剖。对11个髋关节进行宏观评估，同时对3个髋关节进行组织学分析。此外，检查了20块髋骨和股骨的关节面后部附近的骨形态。宏观上，股直肌仅通过其反折头对关节囊有贡献。髂关节肌和髂腰肌与关节囊直接接触。虽然髂关节肌在其全程均附着于关节囊，但髂腰肌通过髂耻滑囊与关节囊相连。微观上，观察到关节囊不同部位的厚度不同，较厚区域对应关节囊韧带。与髂腰肌走行相关的骨性标志包括髂腰肌切迹和腰大肌沟。此外，髂前下棘的分裂和“棘下”分别是股直肌直接头和髂关节肌起点以及髂股韧带内侧束附着的恒定表现。在股骨头处，观察到了普瓦捷小面（35.0%）、艾伦窝（60.0%）和所谓的斑块（50.0%）。总之，我们提出了髋关节四层前方肌肉关节囊复合体的概念，旨在帮助骨科医生进行髋关节置换和保留手术。
