The capsular complex of the hip joint is important for maintaining stability of the hip joint, comprising of the iliofemoral, ischiofemoral, pubofemoral and zona orbicularis ligaments and joint capsule. Dislocation of the hip joint is one of the most common reasons for operative revision within the first year. However, around 7–17% of THAs across the world between 20 required surgical revision for various reasons. This procedure is noted to be highly successful. Increasing numbers of total hip arthroplasties (THA) are performed each year globally. Neither of the funders had a role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. In addition, the author (JT) received the University of Otago, Department of Anatomy Doctoral award, to support her studies and the completion of this work.
The search strategy is detailed in the paper.įunding: We acknowledge support from the German Research Foundation (DFG) ( ) and the University Leipzig within the program of funding Open Access Publishing. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: The articles included in this systematic review may be found on the databases Amed, Embase and Medline via OVID, PubMed, ScienceDirect, Scopus and Web of Science. Received: Accepted: JanuPublished: February 26, 2020Ĭopyright: © 2020 Tomlinson et al. PLoS ONE 15(2):Įditor: John Leicester Williams, University of Memphis, UNITED STATES Increased understanding may highlight the requirement for capsular repair following THA, how this technique may be developed and the contribution of the capsule to joint function and stability.Ĭitation: Tomlinson J, Zwirner J, Ondruschka B, Prietzel T, Hammer N (2020) Innervation of the hip joint capsular complex: A systematic review of histological and immunohistochemical studies and their clinical implications for contemporary treatment strategies in total hip arthroplasty. However, this requires further study, as well as the role of innervation according to sex, specific pathology and other morphometric variables. Also, increasing age may indicate requirements for different strategies to surgically manage the hip capsule. Secondly, the capsule may play a role in pain perception, as the density of innervation appears to be altered in painful individuals. Furthermore, the current literature is unable to reliably confirm the proprioceptive role of the capsule, as no immunohistochemical study to date has reported type I-III mechanoreceptors in the capsule. However, the nomenclature used to describe the distribution of the innervation is inconsistent. Firstly, a role in the mechanics of the hip joint, as mechanoreceptors may be present in the capsule. The literature indicates two primary outcomes and potential clinical implications of the innervation of the capsule. A total of 21 articles on the topic were identified. The literature was sought from databases Amed, Embase and Medline via OVID, PubMed, ScienceDirect, Scopus and Web of Science excluding articles without a histological component and those involving animals. A systematic review of studies investigating the innervation of the hip joint capsular complex and pseudocapsule with histological techniques was performed, as this is not well established. A further reason for the success of this procedure is thought to be the preservation of the innervation of the capsule. This partial restoration of physiological hip stability has resulted in a substantial reduction in post-operative dislocation rates compared to conventional THA without capsular repair. Consequently, to improve this treatment, THA with capsular repair has evolved. Increasing incidence of osteoarthritis is accompanied by a dramatic rise in THAs over the last few decades. The hip joint capsule contributes to the stability of the hip joint and lower extremity, yet this structure is incised and often removed during total hip arthroplasty (THA).
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