Hip Vascularity: A Review of the Anatomy and Clinical Implications. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Seeley, Mark Alan; Georgiadis, Andrew G.; Sankar, Wudbhav N.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 24:Issue 8(2016)
• Publication Date: 2016-08
• Subjects: acetabular blood supply -- artery of ligamentum teres -- hip vascularity -- lateral femoral circumflex artery -- medial femoral circumflex artery; Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-15-00237
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Throughout development, the vascular supply to the proximal femur and acetabulum undergoes a series of changes during which it is susceptible to injury. Before age 3 months, the ligamentum teres and lateral epiphyseal arteries are the dominant supply to the developing head. The dominant supply shifts to the lateral epiphyseal vessels by age 18 months. The distinct metaphyseal and epiphyseal circulations of the adult proximal femur form in adolescence when an increasingly rich metaphyseal circulation supplies the subphyseal region, terminating at the physeal plate. The acetabular blood supply derives from two independent systems, with the dominance of each changing throughout maturity. Most descriptions of the vascular contributions to the proximal femur and acetabulum have been gross anatomic and histologic studies. Advanced imaging studies (eg, CT angiography, perfusion MRI) have added to our understanding of the vascular anatomy of the proximal femur and acetabulum, its changes throughout development, and its clinical implications.