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Related Concept Videos

Psychosurgery01:30

Psychosurgery

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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
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Related Experiment Video

Updated: Jan 10, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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The Layer + Model: Incorporating Psychosocial Considerations into Hip Preservation Surgery.

A L Gornitzky1, I Zaltz2, M J Hartwell2

  • 1Department of Orthopaedics, C.S. Mott Children's Hospital, University of Michigan, 1540 E. Hospital Drive, SPC 4241, Ann Arbor, MI, USA. alexgorn@med.umich.edu.

Current Reviews in Musculoskeletal Medicine
|November 19, 2025
PubMed
Summary
This summary is machine-generated.

The Layer+ Model enhances hip pain diagnosis by adding a psychosocial layer to the existing four. This holistic approach improves treatment accuracy for non-arthritic hip pain and hip preservation surgery outcomes.

Keywords:
DysplasiaFemoroacetabular impingementHip preservation surgeryLayer ConceptNon-mechanical painPsychosocial considerations

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Area of Science:

  • Orthopedics
  • Pain Management
  • Psychology

Background:

  • The Layer Concept provides an anatomical framework for diagnosing and treating non-arthritic hip pain.
  • Psychosocial factors significantly influence hip disorder presentation and outcomes after hip preservation surgery (HPS).

Purpose of the Study:

  • To propose the Layer+ Model, a modification of the Layer Concept, to enhance diagnosis and treatment of non-arthritic hip pain.
  • To integrate a psychosocial layer into the existing framework, acknowledging its impact on pain perception and patient outcomes.

Main Methods:

  • Systematic review of existing evidence supporting the inclusion of a psychosocial layer.
  • Highlighting multidisciplinary efforts to address psychosocial factors in HPS.

Main Results:

  • The Layer+ Model incorporates a fifth, psychosocial layer, encompassing factors like pain chronicity, quality of life, mental health, and social well-being.
  • Evidence supports the significant impact of these psychosocial variables on perceived pain and patient-reported outcomes.

Conclusions:

  • A comprehensive understanding of all five layers (osseous, inert, contractile, neuromechanical, and psychosocial) is crucial for accurate diagnosis and personalized treatment of non-arthritic hip pain.
  • The Layer+ Model facilitates the development of multidisciplinary strategies for screening and managing psychosocial risk factors around HPS.