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The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment
Peter Draovitch1, Jaime Edelstein, Bryan T Kelly
1Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA, draovitchp@hss.edu.
Current Reviews in Musculoskeletal Medicine
|February 29, 2012
Summary
Understanding non-arthritic hip pain has advanced, but differentiating pain sources remains challenging. Dr. Bryan Kelly's Layer Concept offers a systematic approach to identify hip pathology and pain generators for effective treatment.
Area of Science:
- Orthopedic Surgery
- Hip Biomechanics
- Pain Management
Background:
- Significant advancements in understanding non-arthritic hip pain have occurred.
- Subtle bony abnormalities like femoroacetabular impingement can cause hip pain.
- Differentiating the underlying pathology from the pain generator is crucial for effective treatment.
Purpose of the Study:
- To introduce and explain the Layer Concept for evaluating hip pain.
- To provide a systematic framework for identifying hip pathology and pain generators.
- To guide treatment strategies based on a layered understanding of hip structures.
Main Methods:
- The article discusses a four-layer model for hip pain assessment.
- Layer I: Osseous layer
- Layer II: Inert tissue layer
- Layer III: Contractile layer
- Layer IV: Neuromechanical layer
Main Results:
- The Layer Concept provides a structured method to differentiate hip pathology from pain generators.
- This systematic approach aids in determining the source of pain within the hip.
- Understanding the specific layer involved facilitates targeted treatment implementation.
Conclusions:
- The Layer Concept offers a valuable framework for clinicians managing non-arthritic hip pain.
- Accurate identification of pain generators through this layered approach is essential for successful treatment outcomes.
- Further application of the Layer Concept can refine hip pain diagnosis and management strategies.
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