DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20175461

Abnormal ossified structures around the hip joint and its clinical implications

Kosuri Kalyan Chakravarthi, Siddaraju K. S., Nelluri Venumadhav, Sangeeta Atamaram Bali

Abstract


Background: The hip joint is the body’s second largest weight-bearing joint forms a connection from the lower limb to the pelvic girdle. It is formed by an articulation between the pelvic acetabulum and the head of the femur. Ankylosis or fusion of the joint, ossification of the adjacent ligaments and calcific tendinitis of adjacent muscles can decrease the mobility of the joint. The study was undertaken to evaluate the incidence of abnormal ossified structures around the hip joint.

Methods: This study was carried out on 228 dry human hip bones (right- 114 and left-114) and 228 dry human femur bones (right- 114 and left-114) irrespective of age and sex at Varun Arjun medical college-Banthra, UP, KMCT Medical College, Manassery-Calicut and Melaka Manipal Medical College-Manipal. All the hip and femur bones were macroscopically inspected for the abnormal ossified structures around the pelvic acetabulum and upper end of the femur. Photographs of the abnormal ossified structures were taken for proper documentation.

Results: Very rare and unusual unilateral ossified and complete fused left hip joint was noted (0.43%). Unilateral ossified acetabular labrum with ossified transverse acetabular ligament was noted in seven right hip bones (3.07%). Unusual ossified fibrous capsule on the posterior aspect of neck of femur was noted in 4 left sided femur bones (1.75%). Unusual unilateral ossified deposits near the greater trochanter and intertrochanteric line of femur was noted in nine left sided femur bones (3.94%).

Conclusions: Anatomical knowledge of ankylosis of hip joint, ossification of the ligaments and muscles tendons around the hip joint as found in the present study made this study unique such abnormal ossifications may be helpful for clinicians, radiologists and surgeons for differential diagnosis and can be implicated in the development of innovative treatments of hip joint and hip pains.


Keywords


Ankylosis, Ossification, Trendelenberg’s sign, Trochanteric pain syndrome

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References


Joshi AB, Markovic L, Hardinge K, Murphy JC. Conversion of a fused hip to total hip arthroplasty. J Bone Joint Surg. 2002;84-A(8):133-41.

Eyal Amar, Zachary T. Sharfman, Ehud Rath. Heterotopic ossification after hip arthroscopy. J Hip Preservation Surg. 2015; 2(4):355-63.

Hardinge K, Williams D, Etienne A, MacKenzie D, Charnley J. Conversion of fused hips to low friction arthroplasty. J Bone Joint Surg. 1977;59-B(4):38-92.

Kilgus DJ, Amstutz HC, Wolgin MA, Dorey FJ. Joint replacement for anky-losed hips. J Bone Joint Surg. 1990;72(1):4M4.

Howard MB, Bruce WJ, Walsh W, Goldberg JA. Total hip arthroplasty for arthrodesed hips. J Orthop Surg. 2002;10(1):29-33.

Kim YL, Shin SI, Nam KW, Yoo JJ, Kim YM, Kim HJ. Total hip arthroplasty for bilaterally ankylosed hips. J Arthroplasty. 2007;22(7):1037-41.

Hamadouche M, Kerboull L, Meunier A, Courpied JP, Kerboull M. Total hip arthroplasty for the treatment of ankylosed hips: a five to twenty-one-year follow-up study. J Bone Joint Surg. 2001;83-A (7):992-8.

Strathy GM, Fitzgerald JR. Total hip arthroplasty in the ankylosed hip. A ten-year follow-up. J Bone Joint Surg. 1988;70(7):963-6.

Chakravarthi KK, Venumadhav N, Ravindranath G. Abnormal bone outgrowths and osseous structures around the foramen ovale may leads to mandibular compression or entrapment neuropathy. Int J Bioassays. 2013;2:922-25.

Chakravarthi KK, Sarath Babu K. An anatomical study of the pterygo-alar bar and porus crotaphitico buccinatorius. Int J Med Health Sci. 2012;1:3-9.

Kosuri KC, Venumadhav N. Ossified Ligamentum Longitudinale Anterius in Adult Human Dry Vertebrae. J Clinic Diag Res: JCDR. 2014;8(8):AC04.

Ninomiya S, Shimabukuro A, Tanabe T, Kim YT, Tachibana Y. Ossification of the acetabular labrum. J Orthop Sci. 2000;5:511-4.

Corten K, Ganz R, Chosa E, Leunig M. Bone apposition of the acetabular rim in deep hips: A distinct finding of global pincer impingement. J Bone Joint Surg. 2011;93:10-6.

Altman RD, Gold GE. Atlas of individual radiographic features in osteoarthritis, revised. Osteoarthritis Cartilage. 2007;15:A1-A56.

Byers PD, Contepomi CA, Farkas TA. A post mortem study of the hip joint. Including the prevalence of the features of the right side. Ann Rheum Dis. 1970;29:15-31.

Martinez AE, Li SM, Ganz R, Beck M. Os acetabuli in femoro-acetabular impingement: Stress fracture or unfused secondary ossification centre of the acetabular rim? Hip Int. 2006;16:281-6.

Standring S. Gray’s Anatomy: Anatomical Basis of Clinical Practice. 39th Ed., London, Elsevier Churchill-Livingstone. 2008;1389-90.

A. Perumal, S.Sathya. Ossified transverse acetabular ligament-an osteological study. Int J Cur Res Rev. 2014;06(08):37-41

Jones GB, England E. Acute episodes with calcification around the hip joint. J Bone Joint Surg. 1955;37:448-52.

Hayes CW, Rosenthal DI, Plata MJ, Hudson TM. Calcific tendinitis in unusual sites associated with cortical bone erosion. AJR Am J Roentgenol. 1987;149:967-70.

Wepfer JF, Reed JG, Culen GM, McDevitt WP. Calcific tendinitis of the gluteus maximus tendon (gluteus maximus tendinitis). Skeletal Radiol. 1983;9:198-200.

Goldenberg, Raphael R.; Leventhal, Gottlieb S. J Bone Joint Surg. 1936;18(1):205-11.