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BACKGROUND: Radiographs are useful for the initial evaluation of the hip joints. The information can be utilized for the betterment of animal health or other goals such as anatomic studies and gait analysis, among others. Therefore, this study aimed to evaluate radiographic measurements of the hip joint in capuchin monkeys, kept under human care at a reference center for wildlife. METHODS: Twelve capuchin monkeys (Sapajus spp.) (three adult males, seven adult females, and two sub-adult females) were evaluated. Ventrodorsal radiographic views were taken under chemical restraint. All measurements on the digital images were performed in triplicate by one examiner. RESULTS AND CONCLUSIONS: None of the measurements evaluated were statistically different between males and females. No statistical differences were found between hind limbs. The mean (±SD) Norberg angle was 104.92° (±2.82°) and the Wiberg angle was 15.26° (±1.86°). The percentage of the femoral head covered by the acetabulum was 68.57% (±3.65%) and the acetabular index depth to width ratio was 54.66% (±3.85%). In conclusion, the radiographic measurements showed certain morphological features of the hip joint in Sapajus spp. that contribute to improving species knowledge.

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Humans exhibit unique skeletal muscle morphologies that are known to matter in upright bipedalism. However, their relevance to the ease of leg swing, which limits locomotion performance, remains unclear. Here, we aimed to examine muscle mass distribution within the human leg and the effect of each muscle on the ease of leg swing. We calculated the mass, center of mass position, and moment of inertia around the hip extension-flexion axis for all leg muscles by using a publicly available dataset of the 3D reconstruction of the musculoskeletal components in human male and female legs. The leg muscles showed a top-heavy-bottom-light tapering trend; muscles far from the hip joint tended to have smaller masses. Interestingly, however, the soleus exhibited sizable mass for its location. Consequently, the moment of inertia of the soleus was exceptionally greatest, accounting for approximately one-quarter of that of all muscles. These results indicate that compared to the other muscles the soleus muscle has a much larger effect on the leg moment of inertia and uniquely makes humans difficult to swing the leg, although the leg muscles basically show the top-heavy bottom-light tapering trend favoring the leg swing. Our findings highlight a novel functional consequence of human body evolution, suggesting that muscular enlargement for postural stability and endurance capacity has compromised the locomotion speed during the adaptation to bipedalism.

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PURPOSE: To compare different types of short stems (SS) in terms of native hip geometry reproducibility, analyzing centrum-collum-diaphyseal angle (CCD) and femoral offset (FO). These parameters allow the SS to be adapted to patient's anatomy in order to ensure better functional outcomes in total hip arthroplasty (THA). METHODS: A total of 387 cases of SS met the inclusion criteria. CCD and FO were measured using MediCAD® software Version 6 in preoperative (preop-) and postoperative (postop-) X-rays at 6-12 months after surgery. Considering preop-CCD, the sample was divided into three groups: ≤ 124.9° (A); 125°-129.9° (B); and ≥ 130°(C). Preop- and postop-CCD and FO and the respective average difference (Δ) were examined considering the SS individually and within groups, to verify reproducibility of these parameters. RESULTS: The SS considered were eight: Fitmore Zimmer, Pulchra Adler, TRIS Adler, Trifit Corin, Trilock Depuy, Actis Depuy, Profemur Microport, and SMF Smith&Nephew. Groups A, B, and C consisted, respectively, of 113, 124, and 150 cases. Considering all cases, there was a statistically significant (p < 0.05) increase in CCD and FO with surgery. Overall, Trifit and Trilock stems were the best in reproducing preop-CCD, Trifit itself followed by Pulchra and Profemur for preop-FO. In groups A and C, the reproduction of preop-CCD was better than preop-FO, in contrast in group B. With regard to preop-CCD reproduction, in group A Trifit and Pulchra, in group B Fitmore and Trifit, and in group C Fitmore and Pulchra were the best. Fitmore in group A, SMF in group B, Pulchra and Trilock in group C were the worst in reproducing preop-FO. CONCLUSION: Each hip anatomy is unique, and reproduction of preop-CCD and preop-FO can be achieved with different SS characteristics. Accurate knowledge of the stems and performing correct preop- planning are crucial to allow the best restoration of the patient's native hip geometry in THA.

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BACKGROUND: The acetabular sourcil is commonly interpreted as a reliable radiographic representation of the weightbearing dome of the acetabulum, despite limited modern data. Assessment of weightbearing acetabular coverage has been described using both the sourcil edge and bone edge as anatomic landmarks, leading to confusion and potential misguidance in surgical decision-making and thus compromised patient outcomes. PURPOSE/HYPOTHESIS: The purpose of this study was to characterize the 3-dimensional (3D) anatomic correlates of the sourcil-edge and bone-edge radiographic measurements on false-profile radiographs. It was hypothesized that the sourcil edge would represent anterolateral coverage and the bone edge would represent anterior coverage. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 80 hips were grouped by large or small differences between bone-edge and sourcil-edge anterior center-edge angles, based on upper and lower quartiles of discrepancy. Three-dimensional surface mesh models and digitally reconstructed radiographs were generated from hip computed tomography scans. Sourcil-edge and bone-edge anterior center-edge angles were identified on digitally reconstructed radiographs and registered to the 3D models with fiducial markers. Intersections of bone-edge and sourcil-edge projection lines with the acetabular rim were obtained from the 3D models. RESULTS: The bone-edge and sourcil-edge projections intersected the acetabular rim at clockface means of 2:05 ± 0:22 and 1:12 ± 0:25, respectively. The 3D models consistently demonstrated that, in both large- and small-discrepancy groups, the sourcil edge corresponded to the acetabular area just posterior to the anterior inferior iliac spine (AIIS) projection, and the bone edge corresponded to the weightbearing region inferior to the AIIS. Additionally, in large-discrepancy hips, the bone edge corresponded to more prominent acetabular coverage in the region inferomedial to the AIIS when compared with the small-discrepancy hips. CONCLUSION: On false-profile radiographs, the sourcil edge corresponds to superior femoral head coverage, and the bone edge corresponds to anterosuperior coverage. Radiographs with a large discrepancy between sourcil-edge and bone-edge measurements demonstrate acetabular rim prominence in the region of the AIIS. CLINICAL RELEVANCE: Characterizing the anatomic weightbearing regions of the acetabulum represented on false-profile radiographs facilitates improved clinical and intraoperative decision-making in hip preservation surgery, including acetabuloplasty and periacetabular osteotomy.

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The calcar femorale, first identified by Merkel in 1874, plays a pivotal role in the weight-bearing capacity of the proximal femur, and its structural integrity is crucial for the efficient distribution of mechanical loads. Originating at the vertical ridge where the pubofemoral ligament anchors, this bony prominence extends laterally behind the neutral axis from the medial to lateral aspects. Its presence is not merely an anatomical curiosity but significantly influences the biomechanics of the hip joint by providing additional strength and support against compressive forces encountered during activities such as walking or jumping. Despite its clear description in orthopedic texts, misconceptions persist about its exact function and importance. This article delves into the nuanced anatomy and biomechanical properties of the calcar femorale, offering a detailed literature-based examination that demonstrates its relevance in clinical practice. The review highlights how the robustness of the calcar femorale contributes to the prevention of femoral neck fractures as well as the stabilization of hip prostheses. Furthermore, the indispensable role of the calcar femorale in surgical outcomes is discussed, especially in the context of fracture repair and joint replacement, thus illustrating its enduring significance in contemporary medical applications.

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PURPOSE: The short external rotator muscles (SERMs) of the hip are composed of six postural muscles that constitute a single functional unit that is aligned to coapt the articular surfaces of the hip joint, providing dynamic stability. This study aims to provide a morphometric evaluation of this unit that could benefice clinical practice. In particular, the implication of the morphology and direction of the hip triceps tendon when performing a posterolateral approach for total hip arthroplasty. METHODS: A total of 18 cadaveric hips were dissected rigorously. Variations of the origin, course and insertion of all SERMs were recorded and quantified. Measurements were conducted for the following parameters: total muscle lengths, intra-muscular and extra-muscular tendon lengths, muscle sagittal and frontal angles, and femoral neck length. Correlation was searched for between total muscle length and femoral neck length. RESULTS: Results were as follows: (a) the obturator internus and externus muscles insert quasi perpendicularly on the proximal femur, (b) both gemelli take distal insertion onto the tendon of the obturator internus to form the hip triceps tendon, (c) morphometric data of the studied parameters was reported, and (d) moderate to high correlation with femoral neck length was found for all muscles but the quadratus femoris. CONCLUSION: Our results showed that the direction of the hip triceps tendon is always orthogonal to the proximal femur in the frontal plane. Such anatomical reference could be used when performing total hip arthroplasty with the posterolateral approach. Future research is needed to assess whether the easy identification and re-insertion of the hip triceps could reduce leg length discrepancy and offset.

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PURPOSE: This study aimed to investigate the distance and correlation between the anatomy of the anterior side of the hip joint and the femoral nerve. METHODS: Using ten fresh-frozen cadavers with twenty hip joints. We dissected and marked the femoral nerve in the inguinal area. Employing the direct anterior approach, we identified and marked study points, including the superior and inferior points of the anterior rim of the acetabulum, » point, half point, and ¾ point along an imagined line connecting the formers, the inferomedial and mid aspect of the femoral neck, and the soft spot. Coronal plane measurements gauged the distance between these points and the femoral nerve. The collected data were analyzed to assess the distance and correlation. RESULTS: In the coronal plane, the median distance between the inferior point of the anterior rim of the acetabulum and the femoral nerve was 0 millimeters (interquartile range [IQR] 0-0). Likewise, the median distance between the mid aspect of the medial side of the femoral neck and the femoral nerve was 0 millimeters (IQR 0-0). Additionally, the mean distance between the soft spot and the femoral nerve was 1.18 cm (SD 0.63). CONCLUSION: Surgeons approaching the hip joint via the direct anterior approach should be cautious at the inferior point of the anterior rim of the acetabulum and the mid aspect of the femoral neck. The soft spot at the anterior rim of the acetabulum remains safe from direct injury when surgeons use the correct technique during anterior retractor insertion.

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BACKGROUND: Dissatisfaction after total knee arthroplasty (TKA) ranges from 15 to 30%. While patient selection may be partially responsible, morphological and reconstructive challenges may be determinants. Preoperative computed tomography (CT) scans for TKA planning allow us to evaluate the hip-knee-ankle axis and establish a baseline phenotypic distribution across anatomic parameters. The purpose of this cross-sectional analysis was to establish the distributions of 27 parameters in a pre-TKA cohort and perform threshold analysis to identify anatomic outliers. METHODS: There were 1,352 pre-TKA CTs that were processed. A 2-step deep learning pipeline of classification and segmentation models identified landmark images and then generated contour representations. We used an open-source computer vision library to compute measurements for 27 anatomic metrics along the hip-knee axis. Normative distribution plots were established, and thresholds for the 15th percentile at both extremes were calculated. Metrics falling outside the central 70th percentile were considered outlier indices. A threshold analysis of outlier indices against the proportion of the cohort was performed. RESULTS: Significant variation exists in pre-TKA anatomy across 27 normally distributed metrics. Threshold analysis revealed a sigmoid function with a critical point at 9 outlier indices, representing 31.2% of subjects as anatomic outliers. Metrics with the greatest variation related to deformity (tibiofemoral angle, medial proximal tibial angle, lateral distal femoral angle), bony size (tibial width, anteroposterior femoral size, femoral head size, medial femoral condyle size), intraoperative landmarks (posterior tibial slope, transepicondylar and posterior condylar axes), and neglected rotational considerations (acetabular and femoral version, femoral torsion). CONCLUSIONS: In the largest non-industry database of pre-TKA CTs using a fully automated 3-stage deep learning and computer vision-based pipeline, marked anatomic variation exists. In the pursuit of understanding the dissatisfaction rate after TKA, acknowledging that 31% of patients represent anatomic outliers may help us better achieve anatomically personalized TKA, with or without adjunctive technology.

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Although Josias Weitbrecht described the retinacula of the hip joint in his 1742 Syndesmologia, the anatomist Cesare Amantini of Perugia specifically studied the medial retinacula he referred to as the pectineofoveal fold in a late 19th-century monograph. This particular synovial fold stretches from the lesser trochanter to the osteocartilaginous junction of the femoral head along a virtual line connecting the lesser trochanter and the fovea for the ligament of the head. Although mentioned by some anatomists and radiologists, and despite its possible involvement in specific hip joint pathologies (fractures, impingements), it is surprising that Amantini's pectineofoveal fold remains ignored by most anatomy and clinical anatomy books. This study aims to verify if Cesare Amantini effectively drew attention to this synovial fold for the first time and coined the term "pectineofoveal fold," as well as determine whether most classical textbooks (i.e., published from 1890 to 2017) acknowledge the discovery and include it in the description of the hip joint. A possible evolutionary link between this synovial fold and the ambiens and pectineus muscles exists and should be discussed.

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The apophyseal growth plate of the greater trochanter, unlike most other growth plates of the human body, exhibits a curved morphology that results in a divergent pattern resembling an open crocodile mouth on plain antero-posterior radiographs. To quantify the angular alignment of the growth plate and to draw conclusions about the function of the muscles surrounding it, we analyzed 57 MRI images of 51 children and adolescents aged 3-17 years and of six adults aged 18-52 years. We measured the angulation of the plate relative to the horizontal plane (AY angle) and the trajectories of the muscles attaching to the greater trochanter of the proximal femur. From anterior to posterior, the AY angle shows a decrease of 33.44°. In the anterior third, the cartilage is angled at a mean of 51.64°, and in the posterior third, the mean angulation is 18.6°. This indicates that the cartilage in the anterior region of the greater trochanteric apophysis is subject to more vertically oriented force vectors compared to the posterior region, as the growth plates align perpendicular to the force vectors acting on them. Combining the measured muscle trajectories with the physiological cross-sectional areas (PCSA) available from the literature revealed that, in addition to the known internal and external lateral traction ligament systems, a third, dorsally located traction ligament system exists that may be responsible for the dorsal deformation of the AY angle.

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Cam deformity of the proximal femur is a risk factor for early osteoarthritis. While cam morphology is related to mechanical force at a formative time in skeletal growth, the specific problematic forces contributing to the development of cam morphology remain unknown. Individuals with femoroacetabular impingement syndrome exhibit an increased anterior pelvic tilt during walking, which alters their hip joint forces. This study aims to investigate the influence of altered joint force caused by anterior pelvic tilt on proximal femur epiphyseal growth and the potential association between increased anterior pelvic tilt and the development of cam morphology. A computational model is utilized to simulate the endochondral ossification in the proximal femur and predict cam formation. Cartilage growth and ossification patterns for a gait cycle with and without anterior pelvic tilt were modeled. The simulated growth results indicated an increased alpha angle (53° for typically developing to 68° for anterior pelvic tilt) and aspherical femoral head in the model with anterior pelvic tilt. We conclude that anterior pelvic tilt may be sufficient to cause the formation of the cam morphology. Identifying the critical mechanical conditions that increase the risk of cam deformity could help prevent this condition by adjusting the physical activities before skeletal maturity.

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Considering the current widespread use of imaging as an integral part of managing hip pain, variable hip geometries and anatomical variants are increasingly being detected. These variants are commonly found in the acetabulum and proximal femur, as well as the surrounding capsule-labral tissues. The morphology of specific anatomical spaces confined by the proximal femur and the bony pelvis may also vary significantly among individuals. Familiarity with the spectrum of imaging appearances of the hip is necessary to identify variant hip morphologies with or without potential clinical relevance and reduce an unnecessary work-up and overdiagnosis. We describe anatomical variations and variable morphologies of the bony structures comprising the hip joint and the soft tissues, around the hip. The potential clinical significance of these findings is further analyzed in conjunction with the patient's profile.

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OBJECTIVE: The objective of this scoping review was to identify all examples of the application of statistical shape models to the human hip joint, with a focus on applications, population, methodology, and validation. INTRODUCTION: Clinical radiographs are the most common imaging tool for management of hip conditions, but it is unclear whether radiographs can adequately diagnose or predict outcomes of 3D deformity. Statistical shape modeling, a method of describing the variation of a population of shapes using a small number of variables, has been identified as a useful tool to associate 2D images with 3D anatomy. This could allow clinicians and researchers to validate clinical radiographic measures of hip deformity, develop new ones, or predict 3D morphology directly from radiographs. In identifying all previous examples of statistical shape modeling applied to the human hip joint, this review determined the prevalence, strengths, and weaknesses, and identified gaps in the literature. INCLUSION CRITERIA: Participants included any human population. The concept included development or application of statistical shape models based on discrete landmarks and principal component analysis. The context included sources that exclusively modeled the hip joint. Only peer-reviewed original research journal articles were eligible for inclusion. METHODS: We searched MEDLINE, Embase, Cochrane CENTRAL, IEEE Xplore, Web of Science Core Collection, OCLC PapersFirst, OCLC Proceedings, Networked Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Global, and Google Scholar for sources published in English between 1992 and 2021. Two reviewers screened sources against the inclusion criteria independently and in duplicate. Data were extracted by 2 reviewers using a REDCap form designed to answer the review study questions, and are presented in narrative, tabular, and graphical form. RESULTS: A total of 104 sources were considered eligible based on the inclusion criteria. From these, 122 unique statistical shape models of the human hip were identified based on 86 unique training populations. Models were most often applied as one-off research tools to describe shape in certain populations or to predict outcomes. The demographics of training populations were skewed toward older patients in high-income countries. A mean age between 60 and 79 years was reported in 29 training populations (34%), more than reported in all other age groups combined, and 73 training populations (85%) were reported or inferred to be from Europe and the Americas. Only 4 studies created models in a pediatric population, although 15 articles considered shape variation over time in some way. There were approximately equal numbers of 2D and 3D models. A variety of methods for labeling the training set was observed. Most articles presented some form of validation such as reporting a model's compactness (n = 71), but in-depth validation was rare. CONCLUSIONS: Despite the high volume of literature concerning statistical shape models of the human hip, there remains a need for further research in key areas. We identified the lack of models in pediatric populations and low- and middle-income countries as a notable limitation to be addressed in future research.

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Accurate estimation of the hip joint centre (HJC) location is critical for modelling the kinematics and kinetics of the lower limb. Regression equations are commonly used to predict the HJC from anatomical landmarks on the pelvis, such as those published by Tylkowski et al., Andriacchi et al., Bell et al., and Seidel et al. Using a population of 159 CT-segmented pelvises, we assessed the accuracy of these methods as originally reported, and refined their parameters based on our larger cohort. We found the Tylkowski, Bell, and Seidel methods had mean Euclidean errors of 22.5, 26.4, and 17.9 mm, respectively. With new parameters for each method 'back-calculated' from our pelvic population, each method's error was reduced by an average of 69 %, with mean absolute errors of 7.9, 6.6, and 5.9 mm, respectively. For all methods, error has been reduced to below 1 cm, well below published levels for pelvic landmark estimation methods. These results highlight the need to validate and re-calibrate joint centre prediction methods on large, representative datasets to account for natural morphological variations.

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BACKGROUND: Ultrasound (US)-guided intraarticular hip joint injections are commonly performed using an in-plane anterior approach, which has several limitations. OBJECTIVE: To describe and report a "lateral" (lateral to medial) approach for US-guided intraarticular hip injection. DESIGN: Cadaveric investigation. SETTING: Academic institution, department of anatomy. PARTICIPANTS: One cadaveric specimen. METHODS: Both hips of a single cadaver were injected using the US-guided lateral approach. In the left hip, the needle was inserted and kept in situ. The right hip was injected with white-colored water-diluted latex dye. Subsequently, a layer-by-layer anatomical dissection was performed. MAIN OUTCOME MEASURES: Presence and distribution of latex dye and location of needle tip within the joint capsule of the hip. RESULTS: Anatomical dissection of the left and right hips confirmed the correct intraarticular position of the needle tip and the placement of the latex dye, respectively. During layer-by-layer dissection of the left hip, positions of the lateral cutaneous nerve and the lateral circumflex femoral artery were observed anterior to the needle, 30 mm for the nerve and 8 mm for the artery. CONCLUSIONS: This preliminary study demonstrated that the US-guided lateral approach is a convenient technique to access the hip joint in a cadaveric specimen. Compared with the "classical" anterior technique, the lateral approach may provide several advantages, including improved needle visibility, theoretically decreased risk of vascular injury, and less risk of needle contamination. Because injury to the lateral epiphyseal arteries is possible when lateral approach is used, caution is required, especially in children. These preliminary conclusions will need to be validated in future/larger clinical studies.

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Anterior hip joint musculature is classically characterized to include iliacus, psoas major, rectus femoris, and sartorius muscles. A lesser-known muscle, iliocapsularis muscle (ICm), has made infrequent appearances in the literature for the last ~70 years, but potentially has important functional and clinical value. The purpose of this study is to review the historical prevalence of the ICm in peer-reviewed literature (PRL), further explore the prevalence of the muscle in current anatomical textbooks (ATBs), characterize the muscle with a new series of dissections, assess the muscle's perceived importance to clinicians and educators, and comment on the possible functional significance of the muscle. The ICm was mentioned in 28 peer-reviewed articles and the muscle was present in 518 of 521 (99%) dissected hips in 13 publications which assessed prevalence. In an audit of 30 recently published ATBs, three texts mentioned the ICm. In 28 anterior hip dissections performed in the current study, the muscle was present in all hips. Anatomy educators were surveyed to determine if the ICm was presently taught in their curricula, and clinicians of various specialties were surveyed regarding their perceptions of the ICm and its clinical relevance. The ICm inclusivity within anatomical curricula from educators reported 8.5%, while 4% of clinicians reported trainees should have an educational background of the ICm. This study confirms that while the ICm is present within PRL, and is ubiquitous amongst human-donor dissection, the ICm is not mentioned in most ATBs and is absent in the vast majority of anatomical curricula. Lack of inclusion in curricula may lead to a perceived insignificance to currently practicing clinicians despite the potential functional importance at the hip. This discordance suggests that the ICm should be included in ATBs and anatomical curricula so that future clinicians can consider the ICm when evaluating and treating patients.

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Hip flexor musculature was instrumental in the evolution of hominin bipedal gait and in endurance running for hunting in the genus Homo. The iliacus and psoas major muscles were historically considered to have separate tendons with different insertions on the lesser trochanter. However, in the early 20th century, it became "common knowledge" that the two muscles insert together on the lesser trochanter as the "iliopsoas" tendon. We revisited the findings of early anatomists and tested the more recent paradigm of a common "iliopsoas" tendon based on dissections of hips and their associated musculature (n = 17). We rediscovered that the tendon of the psoas muscle inserts only into a crest running from the superior to anterior aspect of the lesser trochanter, separate from the iliacus. The iliacus inserts fleshly into the anterior portion of the lesser trochanter and into an inferior crest extending from it. We developed 3D multibody dynamics biomechanical models for: (a) the conjoint "iliopsoas" tendon hypothesis and (b) the separate insertion hypothesis. We show that the conjoint model underestimates the iliacus' capacity to generate hip flexion relative to the separate insertion model. Further work reevaluating the primate lower limb (including human) through dissection, needs to be performed to develop those datasets for reconstructing anatomy in fossil hominins using the extant phylogenetic bracket approach, which is frequently used for tetrapods clades outside of paleoanthropology.

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We continued direct morphological studies of the canid coxofemoral joint, considering early-life spatial relationships around the locus of the proximocaudal joint capsule insertion. Our primary goal was to elucidate the postnatal developmental gross anatomy of the proximocaudal femur, among juveniles across Canidae. From an original database of 267 independent (museum) specimens from 11 canid taxa and 1 hybrid taxon, we identified 29 ancient or modern candidate juvenile specimens (nine taxa and one hybrid taxon). Based on optimal ability to recognize landmarks, the best photographic data were categorized into five groups of four each (n = 20). The data groups approximated early juvenile, early-mid juvenile, mid-juvenile, mid-late juvenile; and young adult stages. In this descriptive photographic essay, we demonstrate the developmental spatial proximity among (a) the dorsal meeting of the respective lateral and medial extensions from the growth centers of the femoral head and greater trochanter; (b) the caudodorsal aspect of the coxofemoral joint capsule attachment; (c) a segment of the proximocaudal femoral shaft physis; and (d) an eventual associated mineralized prominence. The latter occurs frequently but not universally, suggesting natural population variability across taxa. Across taxa and juvenile age categories, the morphology thus supports developmental conservation among ancient and modern Canidae. The biomechanical and biological cause-effect implications are not yet clear. For zoological purposes, we apply the term postdevelopmental mineralized prominence to the residual caudolateral surface feature. We extend the original anatomical work of Morgan in zoological and phylogenic arenas, using direct observation of cleared skeletal specimens.

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SUMMARY: Anatomic variations in hip joint are one of the risk factors for the occurrence of osteoarthritis of that part of locomotor system. Due to different age structure and a special way of conducting physical activity in the army, it is justified to presume the presence of even other risk factors which relate to the aging process, carrying of oversize weight and performing higher amplitudes of movement under load. The objective of the study related to determining the existence of eventual anatomic variations in the hip joint in soldiers of different age. This cross-sectional study covers 240 soldiers of Montenegro Army, divided into 8 age groups. Gathered data for morphological measures hip width and hip circumference were processed using the basic statistics, multivariate and univariate of variance and Tukey's Honestly Significant Difference test-HSD. The differences were considered statistically significant for p≤0.05. It was determined that for both morphological measures there are differences between soldiers of certain age. This is confirmed also by drastic deviations between certain age groups obtained for the defined level of statistical significance. The most pronounced is the detection of the annual increase of hip width of soldiers which is higher for 0.38 mm compared to general population. Based on the obtained results the existence of anatomic variations in soldiers' hip joints is stated. The confirmed anatomic changes in conjunction with other risk factors may lead to hip osteoarthritis, i.e to soldiers' health condition impairment. It is necessary to conduct longitudinal studies on the same examinees with precise diagnostics.

RESUMEN: Las variaciones anatómicas en la articulación coxal son uno de los factores de riesgo de la osteoartritis de esa zona del sistema locomotor. Debido a la diferente estructura respecto a la de edad y una forma especial de realizar la actividad física en el ejército, se justifica presumir la presencia de otros factores de riesgo que se relacionan con el proceso de envejecimiento, el transporte de peso sobredimensionado y la realización de mayores amplitudes de movimiento bajo carga. El objetivo del estudio fue determinar la existencia de eventuales variaciones anatómicas en la articulación coxal en soldados de diferentes edades. Este estudio transversal incluyó 240 soldados del Ejército de Montenegro, divididos en 8 grupos de edad. Los datos recopilados para las medidas morfológicas del ancho y la circunferencia de la articulación coxal se procesaron utilizando las estadísticas básicas, la varianza multivariada y univariada y la prueba HSD de diferencia significativa de Tukey. Las diferencias fueron consideradas estadísticamente significativas para p≤0,05. Se determinó que para ambas medidas morfológicas existen diferencias entre soldados de cierta edad. Esto fue confirmado también por las desviaciones drásticas entre ciertos grupos de edad obtenidos para el nivel definido de significación estadística. El más pronunciado es la detección del aumento anual del ancho de cadera de los soldados, que es superior en 0,38 mm en comparación con la población general. En base a los resultados obtenidos se afirma la existencia de variaciones anatómicas en las articulaciones coxales de los soldados. Los cambios anatómicos confirmados junto con otros factores de riesgo pueden conducir a la osteoartritis de cadera, es decir, al deterioro del estado de salud de los soldados. Es necesario realizar estudios longitudinales en los mismos examinados con diagnósticos precisos.

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Recently, pathological changes in the fat pad on the anterior inferior iliac spine (AIIS), between the proximal rectus femoris and joint capsule, have been highlighted as a cause of anterior hip pain. However, precise fat pad features, such as the spatial distribution distal to the AIIS, histological features, and in vivo tissue elasticity, remain unclear. This study aimed to investigate the morphological characteristics of the fat pad on the AIIS. Four hips from four cadaveric donors were both macroscopically and histologically investigated, and eight hips from four volunteers were assessed using ultrasonography. The fat pad on the AIIS was also surrounded by the iliopsoas and gluteus minimus, extending distally to the superficial portion of the vastus lateralis, and the anterior portion of the gluteus maximus tendon. Histological analysis revealed that the fat pad was composed of loose connective tissue. Based on the ultrasonography, the shear wave velocity in the fat pad was significantly lower than that in the joint capsule. Conclusively, the pathological adhesion between the joint capsule and pericapsular muscles, if caused by fat pad fibrosis, may occur following the abovementioned fat pad spatial distribution.

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