Abstract
BackgroundThe ligaments in coherence with the capsule of the hip joint are known to contribute to hip stability. Nevertheless, the contribution of the mechanical properties of the ligaments and gender- or side-specific differences are still not completely clear. To date, comparisons of the hip capsule ligaments to other tissues stabilizing the pelvis and hip joint, e.g. the iliotibial tract, were not performed.Materials & MethodsHip capsule ligaments were obtained from 17 human cadavers (9 females, 7 males, 13 left and 8 right sides, mean age 83.65 ± 10.54 years). 18 iliofemoral, 9 ischiofemoral and 17 pubofemoral ligaments were prepared. Uniaxial stress-strain properties were obtained from the load-deformation curves before the secant elastic modulus was computed. Strain, elastic modulus and cross sections were compared.ResultsStrain and elastic modulus revealed no significant differences between the iliofemoral (strain 129.8 ± 11.1%, elastic modulus 48.8 ± 21.4 N/mm2), ischiofemoral (strain 128.7 ± 13.7%, elastic modulus 37.5 ± 20.4 N/mm2) and pubofemoral (strain 133.2 ± 23.7%, elastic modulus 49.0 ± 32.1 N/mm2) ligaments. The iliofemoral ligament (53.5 ± 15.1 mm2) yielded a significantly higher cross section compared to the ischiofemoral (19.2 ± 13.2 mm2) and pubofemoral (15.2 ± 7.2 mm2) ligament. No significant gender- or side-specific differences were determined. A comparison to the published data on the iliotibial tract revealed lower elasticity and less variation in the ligaments of the hip joint.ConclusionComparison of the mechanical data of the hip joint ligaments indicates that their role may likely exceed a function as a mechanical stabilizer. Uniaxial testing of interwoven collagen fibers might lead to a misinterpretation of the mechanical properties of the hip capsule ligaments in the given setup, concealing its uniaxial properties. This underlines the need for a polyaxial test setup using fresh and non-embalmed tissues.
Highlights
Beside the stability-maintaining configured bony shape, both the passive stabilizers and active stabilizers preserve hip stability [1]
Hip Capsule Ligaments Are Similar in Stress-Strain Data
Comparison of the mechanical data of the hip joint ligaments indicates that their role may likely exceed a function as a mechanical stabilizer
Summary
Beside the stability-maintaining configured bony shape, both the passive stabilizers (hip capsule and ligaments) and active stabilizers (external rotators, the gluteal muscles and the rectus femoris) preserve hip stability [1]. The hip capsule ligaments, namely the iliofemoral ligament (IF), ischiofemoral ligament (IS) and pubofemoral ligament (PF), are known to guide and restrict the maximum possible range of motion and translation increasing hip joint stability [3,4]. Transecting or venting these ligaments, as done in arthroplasty or arthroscopy, enhances complications such as dislocations or iatrogenic instability, further illustrating the pivotal role of the hip joint ligaments [5,6,7,8,9,10,11]. Comparisons of the hip capsule ligaments to other tissues stabilizing the pelvis and hip joint, e.g. the iliotibial tract, were not performed.
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