Abstract：
UNASSIGNED: The indirect head of the rectus femoris (IHRF) tendon has been used as an autograft for segmental labral reconstruction. However, the biomechanical properties and anatomic characteristics of the IHRF, as they relate to surgical applications, have yet to be investigated.
UNASSIGNED: To (1) quantitatively and qualitatively describe the anatomy of IHRF and its relationship with surrounding arthroscopically relevant landmarks; (2) detail radiographic findings pertinent to IHRF; (3) biomechanically assess segmental labral reconstruction with IHRF, including restoration of the suction seal and contact pressures in comparison with iliotibial band (ITB) reconstruction; and (4) assess potential donor-site morbidity caused by graft harvesting.
UNASSIGNED: Descriptive laboratory study.
UNASSIGNED: A cadaveric study was performed using 8 fresh-frozen human cadaveric full pelvises and 7 hemipelvises. Three-dimensional anatomic measurements were collected using a 3-dimensional coordinate digitizer. Radiographic analysis was accomplished by securing radiopaque markers of different sizes to the evaluated anatomic structures of the assigned hip.Suction seal and contact pressure testing were performed over 3 trials on 6 pelvises under 4 different testing conditions for each specimen: intact, labral tear, segmental labral reconstruction with ITB, and segmental labral reconstruction with IHRF. After IHRF tendon harvest, each full pelvis had both the intact and contralateral hip tested under tension along its anatomic direction to assess potential site morbidity, such as tendon failure or bony avulsion.
UNASSIGNED: The centroid and posterior apex of the indirect rectus femoris attachment are respectively located 10.3 ± 2.6 mm and 21.0 ± 6.5 mm posteriorly, 2.5 ± 7.8 mm and 0.7 ± 8.0 mm superiorly, and 5.0 ± 2.8 mm and 22.2 ± 4.4 mm laterally to the 12:30 labral position. Radiographically, the mean distance of the IHRF to the following landmarks was determined as follows: anterior inferior iliac spine (8.8 ± 2.5 mm), direct head of the rectus femoris (8.0 ± 3.9 mm), 12-o\'clock labral position (14.1 ± 2.8 mm), and 3-o\'clock labral position (36.5 ± 4.4 mm). During suction seal testing, both the ITB and the IHRF reconstruction groups had significantly lower peak loads and lower energy to peak loads compared with both intact and tear groups (P = .01 to .02 for all comparisons). There were no significant differences between the reconstruction groups for peak loads, energy, and displacement at peak load. In 60° of flexion, there were no differences in normalized contact pressure and contact area between ITB or IHRF reconstruction groups (P > .99). There were no significant differences between intact and harvested specimen groups in donor-site morbidity testing.
UNASSIGNED: The IHRF tendon is within close anatomic proximity to arthroscopic acetabular landmarks. In the cadaveric model, harvesting of the IHRF tendon as an autograft does not lead to significant donor-site morbidity in the remaining tendon. Segmental labral reconstruction performed with the IHRF tendon exhibits similar biomechanical outcomes compared with that performed with ITB.
UNASSIGNED: This study demonstrates the viability of segmental labral reconstruction with an IHRF tendon and provides a detailed anatomic description of the tendon in the context of an arthroscopic labral reconstruction. Clinicians can use this information during the selection of a graft and as a guide during an arthroscopic graft harvest.
UNASSIGNED: To (1) quantitatively and qualitatively describe the anatomy of IHRF and its relationship with surrounding arthroscopically relevant landmarks; (2) detail radiographic findings pertinent to IHRF; (3) biomechanically assess segmental labral reconstruction with IHRF, including restoration of the suction seal and contact pressures in comparison with iliotibial band (ITB) reconstruction; and (4) assess potential donor-site morbidity caused by graft harvesting.
UNASSIGNED: Descriptive laboratory study.
UNASSIGNED: A cadaveric study was performed using 8 fresh-frozen human cadaveric full pelvises and 7 hemipelvises. Three-dimensional anatomic measurements were collected using a 3-dimensional coordinate digitizer. Radiographic analysis was accomplished by securing radiopaque markers of different sizes to the evaluated anatomic structures of the assigned hip.Suction seal and contact pressure testing were performed over 3 trials on 6 pelvises under 4 different testing conditions for each specimen: intact, labral tear, segmental labral reconstruction with ITB, and segmental labral reconstruction with IHRF. After IHRF tendon harvest, each full pelvis had both the intact and contralateral hip tested under tension along its anatomic direction to assess potential site morbidity, such as tendon failure or bony avulsion.
UNASSIGNED: The centroid and posterior apex of the indirect rectus femoris attachment are respectively located 10.3 ± 2.6 mm and 21.0 ± 6.5 mm posteriorly, 2.5 ± 7.8 mm and 0.7 ± 8.0 mm superiorly, and 5.0 ± 2.8 mm and 22.2 ± 4.4 mm laterally to the 12:30 labral position. Radiographically, the mean distance of the IHRF to the following landmarks was determined as follows: anterior inferior iliac spine (8.8 ± 2.5 mm), direct head of the rectus femoris (8.0 ± 3.9 mm), 12-o\'clock labral position (14.1 ± 2.8 mm), and 3-o\'clock labral position (36.5 ± 4.4 mm). During suction seal testing, both the ITB and the IHRF reconstruction groups had significantly lower peak loads and lower energy to peak loads compared with both intact and tear groups (P = .01 to .02 for all comparisons). There were no significant differences between the reconstruction groups for peak loads, energy, and displacement at peak load. In 60° of flexion, there were no differences in normalized contact pressure and contact area between ITB or IHRF reconstruction groups (P > .99). There were no significant differences between intact and harvested specimen groups in donor-site morbidity testing.
UNASSIGNED: The IHRF tendon is within close anatomic proximity to arthroscopic acetabular landmarks. In the cadaveric model, harvesting of the IHRF tendon as an autograft does not lead to significant donor-site morbidity in the remaining tendon. Segmental labral reconstruction performed with the IHRF tendon exhibits similar biomechanical outcomes compared with that performed with ITB.
UNASSIGNED: This study demonstrates the viability of segmental labral reconstruction with an IHRF tendon and provides a detailed anatomic description of the tendon in the context of an arthroscopic labral reconstruction. Clinicians can use this information during the selection of a graft and as a guide during an arthroscopic graft harvest.
摘要：
■股直肌（IHRF）肌腱的间接头已被用作自体移植物，用于节段性唇重建。然而,IHRF的生物力学特性和解剖特征，因为它们与外科应用有关，还没有被调查。
■（1）定量和定性地描述IHRF的解剖结构及其与周围关节镜相关标志的关系；（2）与IHRF相关的详细影像学发现；（3）生物力学评估IHRF的节段性唇重建，包括恢复抽吸密封和接触压力，与髂胫带（ITB）重建相比；（4）评估由移植物收获引起的潜在供体部位发病率。
■描述性实验室研究。
■使用8个新鲜冷冻的人类尸体全骨盆和7个半骨盆进行了尸体研究。使用三维坐标数字化仪收集三维解剖测量值。通过将不同大小的不透射线标记物固定到所分配的髋关节的评估解剖结构来完成射线照相分析。抽吸密封和接触压力测试在6个骨盆上在4个不同测试条件下对每个样本进行了3次试验：完整，唇缘撕裂,用ITB进行隆唇段重建术，和IHRF节段性唇重建。IHRF肌腱收获后，每个完整的骨盆在其解剖方向的张力下测试完整和对侧髋关节，以评估潜在的部位发病率。如肌腱衰竭或骨撕脱。
■间接股直肌附件的质心和后顶点分别位于后10.3±2.6mm和21.0±6.5mm处，2.5±7.8mm和0.7±8.0mm，横向于12:30唇位置的5.0±2.8毫米和22.2±4.4毫米。射线照相,IHRF到以下标志的平均距离如下确定：前髂下棘（8.8±2.5毫米），股直肌直接头（8.0±3.9毫米），12-o时钟位置（14.1±2.8毫米），和3-o时钟位置（36.5±4.4毫米）。在吸入密封测试期间，与完整组和撕裂组相比,ITB组和IHRF重建组均具有显著较低的峰值负荷和较低的能量-峰值负荷(所有比较P=.01~.02).对于峰值载荷，重建组之间没有显着差异，能源,和峰值载荷下的位移。在弯曲60°时，ITB或IHRF重建组的归一化接触压力和接触面积无差异(P>.99).在供体部位发病率测试中，完整标本组和收获标本组之间没有显着差异。
■IHRF肌腱在解剖学上与关节镜下髋臼标志非常接近。在尸体模型中，IHRF肌腱作为自体移植的收获不会导致剩余肌腱的显著供体部位发病率。与ITB相比，用IHRF肌腱进行的节段唇重建表现出相似的生物力学结果。
■这项研究证明了用IHRF肌腱进行节段性唇重建的可行性，并在关节镜唇重建的背景下提供了肌腱的详细解剖描述。临床医生可以在选择移植物期间使用此信息，并在关节镜移植物收获期间作为指导。
■（1）定量和定性地描述IHRF的解剖结构及其与周围关节镜相关标志的关系；（2）与IHRF相关的详细影像学发现；（3）生物力学评估IHRF的节段性唇重建，包括恢复抽吸密封和接触压力，与髂胫带（ITB）重建相比；（4）评估由移植物收获引起的潜在供体部位发病率。
■描述性实验室研究。
■使用8个新鲜冷冻的人类尸体全骨盆和7个半骨盆进行了尸体研究。使用三维坐标数字化仪收集三维解剖测量值。通过将不同大小的不透射线标记物固定到所分配的髋关节的评估解剖结构来完成射线照相分析。抽吸密封和接触压力测试在6个骨盆上在4个不同测试条件下对每个样本进行了3次试验：完整，唇缘撕裂,用ITB进行隆唇段重建术，和IHRF节段性唇重建。IHRF肌腱收获后，每个完整的骨盆在其解剖方向的张力下测试完整和对侧髋关节，以评估潜在的部位发病率。如肌腱衰竭或骨撕脱。
■间接股直肌附件的质心和后顶点分别位于后10.3±2.6mm和21.0±6.5mm处，2.5±7.8mm和0.7±8.0mm，横向于12:30唇位置的5.0±2.8毫米和22.2±4.4毫米。射线照相,IHRF到以下标志的平均距离如下确定：前髂下棘（8.8±2.5毫米），股直肌直接头（8.0±3.9毫米），12-o时钟位置（14.1±2.8毫米），和3-o时钟位置（36.5±4.4毫米）。在吸入密封测试期间，与完整组和撕裂组相比,ITB组和IHRF重建组均具有显著较低的峰值负荷和较低的能量-峰值负荷(所有比较P=.01~.02).对于峰值载荷，重建组之间没有显着差异，能源,和峰值载荷下的位移。在弯曲60°时，ITB或IHRF重建组的归一化接触压力和接触面积无差异(P>.99).在供体部位发病率测试中，完整标本组和收获标本组之间没有显着差异。
■IHRF肌腱在解剖学上与关节镜下髋臼标志非常接近。在尸体模型中，IHRF肌腱作为自体移植的收获不会导致剩余肌腱的显著供体部位发病率。与ITB相比，用IHRF肌腱进行的节段唇重建表现出相似的生物力学结果。
■这项研究证明了用IHRF肌腱进行节段性唇重建的可行性，并在关节镜唇重建的背景下提供了肌腱的详细解剖描述。临床医生可以在选择移植物期间使用此信息，并在关节镜移植物收获期间作为指导。
