ePoster #1203 - ISHA Annual Scientific Meeting 2016

Contribution Of The Pubofemoral Ligament To Hip Stability: A Biomechanical Study

Anthony Khoury, MSc, Dallas, TX UNITED STATES
Ricardo Goncalves Schroder, PT, Dallas, TX UNITED STATES
Eric Johnson, BS, Oklahoma City, OK UNITED STATES
Salvador Campos, MD, Guadalajara MEXICO
Ian James Palmer, PhD, Oklahoma City, OK UNITED STATES
Hal David Martin, DO, Dallas, TX UNITED STATES

Baylor Research Institute, Dallas, TX, UNITED STATES

FDA Status Not Applicable

Summary: Cadaveric specimens were used to evaluate the function of the Pubofemoral Ligament in hip flexion and abduction.

Abstract:
The objective of this study was to determine the contribution of the Pubofemoral Ligament to hip stability during hip flexion and abduction. Thirteen hips from seven fresh-frozen pelvis to toe cadavers were skeletonized from the lumbar spine to the distal femur with great care to maintain capsular ligament integrity. CT imaging was performed to ensure no occult pathological state existed. Specimens were placed on a surgical table in supine with lower extremities resting on a custom designed PVC frame. Hip internal and external rotation was measured with the hip placed into a combination of the following motions: 30, 60, 110 degrees hip flexion and 0, 20, 40 degrees hip abduction. Placements were randomized. The Pubofemoral Ligament was released and measurements were repeated, followed by releasing the Ligamentum Teres. Analysis of the 702 measurements recorded exposes the Pubofemoral Ligament as a main controller of hip internal rotation during hip flexion beyond 30 degrees and abduction. Hip internal rotation was increased up to 438.9% (p<0.001) when the Pubofemoral Ligament was released and 412.9% (p<0.001) when both the Pubofemoral and Teres Ligament were released, compared to the native state. In conjunction with the Ligamentum Teres, the Pubofemoral Ligament is one of two primary stabilizers of the hip in controlling anterior inferior instability. The Pubofemoral Ligament maintains a significant function in limiting hip internal rotation during deep hip flexion beyond 30 degrees and abduction. The present study contributes to the advanced understanding of the biomechanical function provided by the hip capsular ligaments.