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16 - Hip oral core topics

from Section 4 - Adult elective orthopaedics oral

Published online by Cambridge University Press:  22 August 2009

By
Paul A. Banaszkiewicz
Edited by
Paul A. Banaszkiewicz
Edited in association with
Deiary F. Kader  and
Nicola Maffulli
Paul A. Banaszkiewicz
Affiliation:
Queen Elizabeth Hospital, Gateshead
Deiary F. Kader
Affiliation:
Queen Elizabeth Hospital, Gateshead
Nicola Maffulli
Affiliation:
Keele University
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Summary

Anatomy of the hip

Blood supply of femoral head

This is a favourite question in either the basic science or the adult/pathology oral. This may lead into a discussion about avascular necrosis (AVN) of the femoral head. The blood supply has three sources:

  1. Medial circumflex femoral artery is the most important supply; it is a branch of the profunda femoris artery

  2. Lateral circumflex artery supplies the inferior portion; it is a branch of the profunda femoris artery

  3. Artery of the ligamentum teres is a minor blood supply in the adult; it is a posterior branch of the obturator artery

The extracapsular arterial ring gives off ascending cervical arteries known as retinacular arteries. Injury to the retinacular arteries may lead to AVN.

Examination corner

Basic science oral 1

Second question after an initial discussion on the position that a leg assumes after a traumatic posterior and anterior dislocation of the hip.

Examiner: What is the blood supply to the femoral head?

Candidate: The blood supply to the femoral head is derived from the medial and lateral femoral circumflex arteries; these are branches of the profunda femoris artery. They form an extracapsular arterial ring around the base of the trochanter. Ascending cervical arteries are given off this ring and then branch into retinacular arteries, which form a subsynovial intracapsular arterial ring …

The candidate was stopped in mid-sentence by the examiner, who was satisfied with the answer and wanted to move on to another question. This led on to a discussion of AVN of the hip, types of THA to use in a young patient, survival analysis curves, etc.[…]

Type
Chapter
Information
Postgraduate Orthopaedics
The Candidate's Guide to the FRCS (TR & Orth) Examination
 , pp. 155 - 193
Publisher: Cambridge University Press
Print publication year: 2008

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References

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