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Bones of the Lower Limb: Femur and Patella01:16

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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
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Functional Classification of Joints
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Placement of the acetabular component.

D E Beverland1, C K J O'Neill1, M Rutherford2

  • 1Musgrave Park Hospital, Belfast Health and Social Care Trust, Stockman's Lane, Belfast BT9 7JB, UK.

The Bone & Joint Journal
|January 7, 2016
PubMed
Summary
This summary is machine-generated.

This study introduces using the transverse acetabular ligament (TAL) to guide acetabular component placement for hip restoration. Proper positioning controls height, depth, and version, improving anatomical accuracy in hip replacements.

Keywords:
Acetabular cup orientationpatient positioningpelvic orientationtotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Anatomy

Background:

  • Acetabular component placement is critical for successful hip arthroplasty.
  • Current methods for achieving ideal acetabular component positioning are often imprecise.
  • Restoring original hip anatomy is a primary goal in total hip replacement.

Purpose of the Study:

  • To utilize the transverse acetabular ligament (TAL) as a landmark for precise acetabular component placement.
  • To restore the native hip's center, height, depth, and version.
  • To refine surgical techniques for acetabular component implantation.

Main Methods:

  • Employing the TAL and labrum as guides for component height and depth, ensuring it lies just deep to their plane.
  • Positioning the acetabular component face parallel to the TAL and psoas groove to achieve patient-specific version.
  • Utilizing the TAL for version control in dysplastic hips, accounting for bony abnormalities.
  • Recommending 35° apparent operative inclination (AOI) instead of the traditional 45°.
  • Emphasizing meticulous patient positioning in the lateral decubitus position to prevent inclination errors.

Main Results:

  • Positioning the component cradled by and deep to the TAL/labrum, with a size no more than 4mm larger than the original femoral head, restores the hip's center.
  • Aligning the component face with the TAL and psoas groove restores patient-specific version.
  • The TAL is effective for version control, even in dysplastic hips.
  • Patient positioning errors are a significant cause of radiographic inclination deviations (>50°).

Conclusions:

  • The transverse acetabular ligament (TAL) provides a reliable anatomical landmark for controlling acetabular component height, depth, and version.
  • This technique aids in restoring native hip anatomy and optimizing component fit.
  • Careful patient positioning and adjusted operative inclination are crucial for accurate acetabular component implantation.