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Benes M, Kunc V, Nanka O, Kachlik D, Bartak V. Anatomy of the iliopsoas notch and its relationship with morphology of the proximal femur. Surg Radiol Anat 2024; 46:51-57. [PMID: 37982997 DOI: 10.1007/s00276-023-03263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/25/2023] [Indexed: 11/21/2023]
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.
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Affiliation(s)
- Michal Benes
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic.
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Vojtech Kunc
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Clinic of Trauma Surgery, Masaryk Hospital, Usti Nad Labem, Czech Republic
| | - Ondrej Nanka
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06, Prague 5, Czech Republic
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladislav Bartak
- 1st Department of Orthopaedics, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Marshall K, Nair SM, Willmore KE, Beveridge TS, Power NE. Anatomical characterization of the inguinal lymph nodes using microcomputed tomography to inform radical inguinal lymph node dissections in penile cancer. J Surg Oncol 2020; 122:1785-1790. [PMID: 32914446 DOI: 10.1002/jso.26199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/15/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND & OBJECTIVES Radical inguinal lymph node dissections (rILND) for penile cancer risk significant postoperative lymphocele and lymphedema. However, reducing the risk of lymphatic complications is limited by our understanding of lymphatic anatomy. Therefore, this study aims to elucidate the lymphatic anatomy within the current surgical borders of a rILND. METHODS To visualize the position of the lymph nodes, tissue packets excised from the inguinal region of five fresh, male cadavers were imaged using microcomputed tomography (µCT). To standardize the position, rotation and size between specimens, each lymph node packet was aligned using a Generalized Procrustes analysis. RESULTS There was a median of 13.5 lymph nodes (range = 8-18) per packet, with the majority (99%) clustered within a 6 cm radius of the saphenofemoral junction; a region 39%-41% smaller than current surgical borders. No difference existed between the number of nodes between sides, or distribution around the saphenofemoral junction. CONCLUSIONS This study provides the first 3D, in situ, standardized characterization of lymph node anatomy in the inguinal region using µCT. By using knowledge of the normal lymphatic anatomy, this study can help inform the reduction in borders of rILND to limit disruption and ensure a complete lymphadenectomy.
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Affiliation(s)
- Kaitlin Marshall
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada
| | - Shiva M Nair
- Department of Surgery, Urology Division, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada.,Department of Oncology, Surgical Oncology Division, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada
| | - Katherine E Willmore
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada
| | - Tyler S Beveridge
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada
| | - Nicholas E Power
- Department of Surgery, Urology Division, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada.,Department of Oncology, Surgical Oncology Division, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada
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Kuroda Y, Rai A, Saito M, Khanduja V. Anatomical variation of the Psoas Valley: a scoping review. BMC Musculoskelet Disord 2020; 21:219. [PMID: 32276620 PMCID: PMC7149878 DOI: 10.1186/s12891-020-03241-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/26/2020] [Indexed: 12/27/2022] Open
Abstract
Background This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o’clock on the acetabular rim which may have implications with labral pathology. Conclusion This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.
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Affiliation(s)
- Yuichi Kuroda
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Box 37, Hills Road, Cambridge, CB2 0QQ, UK
| | - Ankit Rai
- University of Cambridge, Cambridge, UK
| | - Masayoshi Saito
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Box 37, Hills Road, Cambridge, CB2 0QQ, UK
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Box 37, Hills Road, Cambridge, CB2 0QQ, UK.
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Rajasekhar S, Vasudha TK, Aravindhan K. Sex Determination by Biometry of Anterior Features of Human Hip Bones in South Indian Population. J Clin Diagn Res 2017; 11:AC13-AC16. [PMID: 28764142 DOI: 10.7860/jcdr/2017/27927.10051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/05/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Sex determination is the first step in establishing the identity of skeletal remains. Many studies included biometry of posterior features of hip bone. Very few studies are reported involving the biometry of anterior features of the hip bone. Anterior features of hip bone are important especially, if there is damage to the posterior features of hip bone in cases involving deliberate disfigurement of the body to resist identification of the crime in medicolegal cases. AIM The present study was done to evaluate the effectiveness of anterior border parameters of the hip bone for prediction of sex using discriminant function analysis in South Indian population. MATERIALS AND METHODS A total of 206 dry bones were used (121 male and 85 female) and parameters like the distance between pubic tubercle and anterior rim of acetabulum, vertical acetabular diameter, transverse acetabular diameter, and the distance between pubic tubercle to highest point on the iliopubic eminence were measured using Vernier calipers. Normally distributed variables were compared using Students t-test to analyse the significance. RESULTS There was significant difference between the male and female hip bones of the observed variables with p-value less than 0.05. In parameters like the distance between pubic tubercle to anterior rim of acetabulum and distance between the highest points on iliopubic eminence to pubic tubercle; the values were more in female when compared to males. In parameters like vertical and transverse acetabular diameters; the values in males were more when compared to females. CONCLUSION These parameters of hip bone can be utilised for sex determination in South Indian population.
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Affiliation(s)
- Sssn Rajasekhar
- Assistant Professor, Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - T K Vasudha
- Associate Professor, Department of Anatomy, Subbaiah Medical College, Shivamogga, Karnataka, India
| | - K Aravindhan
- Additional Professor and Head, Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Kim DH, Lee SS, Han SH, Lee UY. A new landmark for measuring the Ischium-Pubis index for sex determination by using three-dimensional models of South Korean population. AUST J FORENSIC SCI 2017. [DOI: 10.1080/00450618.2016.1267796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Dong-Ho Kim
- Catholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
| | - Sang-Seob Lee
- Medical Examiner’s Office, National Forensic Service , Wonju, Republic of Korea
| | - Seung-Ho Han
- Department of Anatomy, School of Medicine, Chungang University , Seoul, Republic of Korea
| | - U-Young Lee
- Catholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea
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