고관절 수술
1) femur neck fracture
2) AVN 대퇴골두 무혈성 괴사 - total Hip
lumbopelvic-hip complex
생체역학적 부하는 추체, sacrum, pelvic brim, hip joint에 가해짐.
- pelvic brim의 원구조는 체중분산에 유리함
hip joint는 ball and socket joint
x-ray와 생체역학
- 아래 사진을 standing position으로 촬영한 거라면 높이가 낮은 좌측 hip joint에 체중부하가 주어지고 있는 것임.
hip joint ligamnet
1) ligamentum teres
2) 3개의 인대구조
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798146/
J Hip Preserv Surg. 2018 Jan; 5(1): 15–22.
Published online 2018 Jan 10. doi: 10.1093/jhps/hnx046
PMCID: PMC5798146
PMID: 29423246
The role of the ligamentum teres in the adult hip: redundant or relevant? A review
John M O’Donnell,
1 Brian M Devitt,2 and Manit Arora1
Author information Article notes Copyright and License information Disclaimer
Go to:
ABSTRACT
The ligamentum teres (LT) has traditionally been described as a redundant structure with no contribution to hip biomechanics or function. There has been renewed interest in the LT as a source of hip pathology due to the high prevalence of LT pathology observed at the time of hip arthroscopy. The LT acts a secondary stabilizer to supplement the work of the capsular ligaments and works in a sling-like manner to prevent subluxation of the hip at the extremes of motion. The presence of free nerve endings within the LT indicates a definite role in pain generation, with the LT undergoing various mechanical and histological adaptations to hip pathology.
닫힌 사슬 보행에서 hip 관절은 external rotation이 쉽게 일어나는 구조 - 팔자걸음
팔은 internal rotation이 쉽게 일어나는 구조
lumbar body
sacrum - ilium = SI joint
Hip
틀어짐은 척추체, 천골, 장골이 통으로 뒤틀림
- acetabulum 위치가 바뀜
- femur 회전이 발생
- knee, ankle 전체가 뒤틀림.
Imagination is more important than knowledge!!
고관절 수술 후 재활
lumbar pain, si joint pain, hip joint pain시 척추-골반-hip, 무릎의 틀어짐
- 이때 관련된 근육작용선(muscle action line)의 이해
https://youtu.be/LUFkj03iAc4