髋关节囊的应用解剖与临床研究的进展

Applied anatomy of reserch progress on hip capsule

目的总结髋关节囊的解剖、生物力学及临床研究进展。方法在中国知网、万方数据、PubMed等中英文数据库中,检索2022年9月之前公开发表的有关髋关节囊的解剖、生物力学及临床研究的文献共1347篇,剔除与研究方向不符、内容重复、质量较低的文献,共纳入文献40篇,并阅读解剖学著作3部,进行相关分析与总结。结果髋关节囊为包绕髋关节的圆筒形纤维结缔组织,周围主要由髂股韧带、坐股韧带、耻股韧带和轮匝带等4条韧带牢固连接,每条韧带都有自己特定的起止点及走行,当前对于这些解剖结构还存在一些不同的观点。髋关节囊周围韧带在维持髋关节功能与稳定方面发挥着重要作用,髂股韧带是髋关节的动静态联合稳定器,坐股韧带和耻股韧带在限制髋关节内旋及外旋方面发挥着不可忽视的作用。此外,轮匝带是保持股骨头稳定性和抵抗髋关节轴向牵引力的重要结构。髋关节术后关节囊修复对髋关节稳定性的作用已较为肯定,但是否需要进行关节囊修复,还要具体考虑手术类型、切口大小和患者自身情况等影响因素。关节囊厚度的变化与关节囊松弛、股骨髋臼撞击症等疾病的发生存在相关性。结论髋关节囊及其周围韧带在维持髋关节稳定中发挥重要作用,与其解剖结构和力学特点关系密切。髋关节囊的修复对髋关节术后增强髋关节稳定性有一定的作用,髋关节囊厚度的变化与多种髋关节疾病的发生相关。正确处理髋关节囊,对术后髋关节的稳定和髋关节疾病的防治具有重要的临床意义。

Objective This work aims to summarize the research progress of anatomy,biomechanics,and clinical treatment of hip capsules.Methods In the Chinese and English databases such as CNKI,Wanfang Data,PubMed,a total of 1347 papers on the applied anatomy,biomechanics,and clinical treatment of hip capsules published before September 2022 were searched.Forty studies were included,and three anatomical works were read for analysis and summary.Results The hip capsule is a cylindrical fibrous connective tissue around the hip joint and is mainly connected and strengthened by four ligaments such as iliofemoral ligament,ischiofemoral ligament,pubofemoral ligament,and orbicularis band.Each ligament has its own specific start and end point and course.Currently,different views on these anatomical structures are available.The ligaments around the hip capsule play an important role in maintaining the function and stability of the hip joint.The iliofemoral ligament is the dynamic and static joint stabilizer of the hip joint.The ischiofemoral and pubofemoral ligaments play an important role in limiting the internal and external rotation of the hip joint.In addition,the chorda tympani is an important structure for maintaining the stability of the femoral head and resisting the axial traction of the hip joint.The role of post-operative joint capsule repair on hip stability has been affirmed.In deciding whether joint capsule repair is needed,specific consideration should be given to the type of surgery,the size of the incision,the patient's situation,and other influencing factors.Changes in joint capsule thickness are correlated with the occurrence of diseases,such as joint capsule laxity and femoroacetabular impingement.Conclusion The capsule of the hip joint and its surrounding ligaments play an important role in maintaining the stability of the hip joint,which is closely related to its anatomical structure and mechanical characteristics.The repair of hip capsule can enhance the stability of hip joint after hip operation.The thickness of the hip capsule is related to the occurrence of many kinds of hip joint diseases.The correct treatment of the hip capsule is of great clinical significance to the stability of the hip joint after operation and the prevention and treatment of hip joint diseases.