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Hip preservation surgery and the acetabular fossa
Pablo A Slullitel1, Daniel Coutu2, Martin A Buttaro1
1'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
Bone & Joint Research
|December 4, 2020
Summary
The acetabular fossa, often overlooked, is crucial for hip development and joint health. Its pulvinar tissue supports cartilage regeneration and load distribution, impacting hip preservation surgery outcomes.
Area of Science:
- Orthopedics
- Developmental Biology
- Regenerative Medicine
Background:
- The acetabular fossa, comprising over half the acetabulum's surface, is often neglected in hip research despite early degeneration signs.
- Its role extends beyond static stability and surgical templating, suggesting a more significant function in hip biomechanics and development.
Purpose of the Study:
- To highlight the underappreciated role of the acetabular fossa and its pulvinar tissue in hip development, function, and disease.
- To emphasize the biological significance of the fossa and pulvinar in hip preservation surgery.
Main Methods:
- Review of anatomical and developmental literature on the acetabular fossa and pulvinar.
- Analysis of the cellular composition and potential biological functions of the pulvinar tissue.
Main Results:
- The acetabular fossa is vital for hip development, providing nutrition via vascularization and synovial fluid, and supplying chondrogenic stem/progenitor cells.
- The pulvinar, a fibrofatty tissue within the fossa, shares developmental origins with synovium and cartilage, actively distributing axial loads.
- Pulvinar tissue contains intra-articular adipose tissue (IAAT) with adipocytes, fibroblasts, leucocytes, and mast cells, implicating it in inflammatory responses.
Conclusions:
- The acetabular fossa and pulvinar are critical anatomical structures with significant biological capacity, influencing hip development and joint health.
- These structures should be considered in surgical decision-making and outcome assessment for hip preservation surgery due to their role in providing cytokines, immune cells, and stem cells.
