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Surgical and Radiologic Anatomy

20-11-2023 | Hip-TEP | Original Article

Anatomy of the iliopsoas notch and its relationship with morphology of the proximal femur

Authors: Michal Benes, Vojtech Kunc, Ondrej Nanka, David Kachlik, Vladislav Bartak

Published in: Surgical and Radiologic Anatomy

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Abstract

Purpose

Discrepancy between the morphology of the acetabular margin and the design of hemispheric acetabular cups used in total hip arthroplasty may produce postoperative hip pain due to an iliopsoas impingement at the iliopsoas notch. This study aimed to determine the anatomical features of the iliopsoas notch in the Central European sample, and to test whether the morphology of the proximal femur affects the size of the iliopsoas notch.

Methods

The sample was composed of 40 matched pairs of dry hip bones and corresponding femora. The depth and length of the iliopsoas notch were measured and correlated with the available demographic data. The anthropometric parameters of the proximal femur were calculated using image-analysis software, and their association with the measurements of the iliopsoas notch was tested.

Results

The iliopsoas notch was present in all specimens and featured four morphological configurations: curved (61.3%), angular (16.2%), irregular (16.2%), and straight (6.3%). Its size was found to be larger in males (P = 0.014 for depth, P < 0.001 for length). No significant difference existed between the sides. The height and age of the specimens did not correlate with the size of the iliopsoas notch. Furthermore, neither the femoral neck version, the lesser trochanteric version, nor the angle between the neck of the femur and the lesser trochanter influenced the dimensions of the iliopsoas notch.

Conclusion

The iliopsoas notch is a consistent landmark of the acetabulum, although its anatomical appearance is widely variable. The iliopsoas notch arrangement cannot be predicted perioperatively based on the morphology of the proximal femur. The various shapes and sex-related differences detected in this study could be used for designing new hip implants or could be utilized during cup positioning in total hip arthroplasty.
Literature
1.
Devi TB, Philip C (2014) Acetabulum-morphological and morphometrical study. Res J Pharm Biol Chem Sci 5:793–799
2.
Domb BG, Shindle MK, McArthur B, Voos JE, Magennis EM, Kelly BT (2011) Iliopsoas impingement: a newly identified cause of labral pathology in the hip. HSSJ 7:145–150 CrossRef
3.
Govsa F, Ozer MA, Ozgur Z (2005) Morphologic features of the acetabulum. Arch Orthop Trauma Surg 125:453–461 CrossRefPubMed
4.
Hert J, Bartak V, Fulin P, Pokorny D, Sosna A (2021) Does the femoral CCD angle measurement in a standard AP projection correlate with the true anatomical shape of the femur? Acta Chir Orthop Traumatol Cech 88:169–175 CrossRefPubMed
5.
Kopydlowski NJ, Tannenbaum EP, Smith MV, Sekiya JK (2014) Characterization of human anterosuperior acetabular depression in correlation with labral tears. Orthop J Sports Med 2:2325967114551328 CrossRefPubMedPubMedCentral
6.
7.
Maruyama M, Feinberg JR, Capello WN, D’Antonio JA (2001) Morphologic features of the acetabulum and femur: anteversion angle and implant positioning. Clin Orthop Relat Res 393:52–65 CrossRef
8.
O’Connor MI (2011) Use of an anatomical acetabular component for treatment of iliopsoas impingement. J Arthoplasty 26(1570):e13–e15
9.
Pachner P (1937) Pohlavní rozdíly na lidské pánvi [Sex differences in the human pelvis]. Česká akademie věd a umění, Praha
10.
11.
Sachdeva K, Singla RK, Kalsey G (2011) The role of the anterior border of the hip bone in sexual dimorphism: a morphometric study in the North Indian population. Med Sci Law 51:208–214 CrossRefPubMed
12.
Schröder RG, Reddy M, Hatem MA, Gomez-Hoyos J, Toyte L, Khoury A, Martin HD (2015) A MRI study of the lesser trochanteric version and its relationship to proximal femoral osseous anatomy. J Hip Preserv Surg 2:410–416 PubMedPubMedCentral
13.
Ueno T, Kabata T, Kajino Y, Inoue D, Ohmori T, Tsuchiya H (2018) Risk factors and cup protrusion thresholds for symptomatic iliopsoas impingement after total hip arthroplasty: a retrospective case-control study. J Arthroplasty 33:3288–3296 CrossRefPubMed
14.
Vandenbussche E, Saffarini M, Deloge N, Moctezuma JL, Nogler M (2007) Hemispheric cups do not reproduce acetabular rim morphology. Acta Orthop 78:327–332 CrossRefPubMed
15.
Metadata
Title
Anatomy of the iliopsoas notch and its relationship with morphology of the proximal femur
Authors
Michal Benes
Vojtech Kunc
Ondrej Nanka
David Kachlik
Vladislav Bartak
Publication date
20-11-2023
Publisher
Springer Paris
Keywords
Hip-TEP
Hip-TEP
Published in
Surgical and Radiologic Anatomy
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-023-03263-z