by Morteza Kalhor, Martin Beck, Thomas W. Huff, and Reinhold Ganz

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Presentation transcript:

by Morteza Kalhor, Martin Beck, Thomas W. Huff, and Reinhold Ganz Capsular and Pericapsular Contributions to Acetabular and Femoral Head Perfusion by Morteza Kalhor, Martin Beck, Thomas W. Huff, and Reinhold Ganz J Bone Joint Surg Am Volume 91(2):409-418 February 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Posterior aspect of the right hip, demonstrating the anatomic position of the deep branch of the medial femoral circumflex artery. 1 = greater trochanter, 2 = trochanteric branch of the medial femoral circumflex artery, 3 = quadratus femoris muscle, 4 = obt... Posterior aspect of the right hip, demonstrating the anatomic position of the deep branch of the medial femoral circumflex artery. 1 = greater trochanter, 2 = trochanteric branch of the medial femoral circumflex artery, 3 = quadratus femoris muscle, 4 = obturator externus muscle, 5 = obturator internus and gemellus muscles, and 6 = anastomotic branch to the inferior gluteal artery. cran = cranial, and lat = lateral. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Anterior aspect of the right hip after retraction of the iliopsoas and tensor fasciae latae muscles, showing the joint capsule and the capsular branch of the lateral femoral circumflex artery. 1 = tensor fasciae latae muscle, 2 = iliopsoas muscle, 3 = anter... Anterior aspect of the right hip after retraction of the iliopsoas and tensor fasciae latae muscles, showing the joint capsule and the capsular branch of the lateral femoral circumflex artery. 1 = tensor fasciae latae muscle, 2 = iliopsoas muscle, 3 = anterior joint capsule with the rectus muscle turned distally, and 4 = rectus femoris muscle, reflected distally. cran = cranial, and lat = lateral. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Anterolateral aspect of the right hip after detachment of the abductor, rectus femoris, and tensor muscles, demonstrating a capsular branch and an anastomosis between the ascending branch of the lateral femoral circumflex artery and the supra-acetabular bra... Anterolateral aspect of the right hip after detachment of the abductor, rectus femoris, and tensor muscles, demonstrating a capsular branch and an anastomosis between the ascending branch of the lateral femoral circumflex artery and the supra-acetabular branch of the superior gluteal artery. 1 = greater trochanter, 2 = vastus lateralis muscle, 3 = vastus intermedius muscle, 4 = tensor fasciae latae muscle (turned medially and distally), 5 = lateral femoral circumflex artery, 6 = iliopsoas muscle, 7 = ascending branch of the lateral femoral circumflex artery, 8 = hip joint capsule (femoral attachment), 9 = anterior end of the supra-acetabular branch of the superior gluteal artery anastomosing with the lateral femoral circumflex artery, and 10 = inferior iliac spine (rectus femoris tendon detached). cran = cranial, and lat = lateral. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Posterolateral aspect of the right hip after retraction of the gluteal muscles and short external rotators to demonstrate the periosteal arteries as well as the supra-acetabular branch of the superior gluteal artery before capsulotomy. 1 = greater trochante... Posterolateral aspect of the right hip after retraction of the gluteal muscles and short external rotators to demonstrate the periosteal arteries as well as the supra-acetabular branch of the superior gluteal artery before capsulotomy. 1 = greater trochanter, 2 = hip capsule, 3 = sciatic nerve, 4 = short external rotators (obturator internus and gemellus muscles) detached from the greater trochanter and retracted, 5 = acetabular branch of the inferior gluteal artery, and 6 = supra-acetabular branch of the superior gluteal artery. cran = cranial, and med = medial. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Posterior aspect of the acetabulum and the hip joint after capsulotomy to show the acetabular branches of the gluteal arteries and anastomoses between them. 1 = greater trochanter (osteotomized), 2 = deep branch of the medial femoral circumflex artery (intr... Posterior aspect of the acetabulum and the hip joint after capsulotomy to show the acetabular branches of the gluteal arteries and anastomoses between them. 1 = greater trochanter (osteotomized), 2 = deep branch of the medial femoral circumflex artery (intra-capsular part and retinacular arteries), 3 = lesser sciatic notch, 4 = acetabular branch of the inferior gluteal artery, 5 = sciatic nerve, 6 = inferior gluteal artery, 7 = acetabular branch of the superior gluteal artery, 8 = supra-acetabular branch of the superior gluteal artery, and 9 = terminal vessel supplying the labrum. cran = cranial, and lat = lateral. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Posterior aspect of the right hip, demonstrating the distal branch of the inferior gluteal artery to the acetabulum and hip capsule. 1 = greater trochanter, 2 = quadratus femoris muscle, 3 = sciatic nerve, 4 = inferior gemellus muscle, 5 = inferior gluteal ... Posterior aspect of the right hip, demonstrating the distal branch of the inferior gluteal artery to the acetabulum and hip capsule. 1 = greater trochanter, 2 = quadratus femoris muscle, 3 = sciatic nerve, 4 = inferior gemellus muscle, 5 = inferior gluteal artery, and 6 = branch of the inferior gluteal artery to the hip capsule and acetabulum. cran = cranial, and lat = lateral. Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Hip from the posterior view, demonstrating the periacetabular vascular ring and anastomoses between distal and proximal vessels. 1 = superior gluteal artery, 2 = inferior gluteal artery, 3 = medial femoral circumflex artery, 4 = lateral femoral circumflex a... Hip from the posterior view, demonstrating the periacetabular vascular ring and anastomoses between distal and proximal vessels. 1 = superior gluteal artery, 2 = inferior gluteal artery, 3 = medial femoral circumflex artery, 4 = lateral femoral circumflex artery, and 5 = perforating vessels (cut surface). Morteza Kalhor et al. J Bone Joint Surg Am 2009;91:409-418 ©2009 by The Journal of Bone and Joint Surgery, Inc.