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A systematic review and meta-analysis of iliocapsularis muscle: an important landmark in orthopedic surgery

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Abstract

Purpose

Iliocapsularis (IC) is a small muscle overlying the capsule of the hip joint. Although recent attention is being given to this muscle by orthopedic surgeons who encounter it during the anterior approach to total hip arthroplasty, little is known about its anatomical features. The aim of this study was to review the anatomy of IC, and describe its’ origin, insertion, blood supply, innervation, muscle fiber characteristics and size. The function, clinical relevance and comparative anatomy of IC were also appraised.

Methods

Using Evidence-Based Anatomy methodology, electronic databases were searched with the terms “iliocapsularis”, “iliacus minor”, “iliotrochantericus”, and “ilioinfratrochantericus” to identify eligible studies.

Results

Six studies (n = 287 lower limbs) examining the anatomy of IC were included. The pooled prevalence (PP) of the IC was 98.7% (95% CI 96.5–100.0). It arises from the inferior facet of the anterior inferior iliac spine (AIIS) and attaches inferior to the lesser trochanter. Attached to the anteromedial capsule along its entire length, IC has the largest capsular contribution of any of the hip muscles (73.8 ± 27.3 × 16.1 ± 4.4 mm). Thus, it is an important landmark in anterior surgical approaches to the hip joint.

Conclusion

The anatomy of IC is becoming more relevant with the increasing use of anterior approaches to hip surgery. With attachments to the AIIS, the lesser trochanter as well as the length of the capsule, this muscle is an important landmark in total hip arthroplasty.

Level of evidence

Level V

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Adapted from Mashriqi et al. [18] (http://creativecommons.org/licenses/by-nc-nd/3.0/))

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Funding

No funding was received for this research.

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Authors and Affiliations

  1. Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa

    Kerri Keet & Rudolph Venter

  2. International Evidence-Based Anatomy Working Group, Jagiellonian University, 12 Kopernika Street, 31-034, Kraków, Poland

    Kerri Keet, Isaac Cheruiyot, Brandon Michael Henry, Krzysztof A. Tomaszewski & Przemysław A. Pękala

  3. Department of Human Anatomy, School of Medicine, University of Nairobi, PO Box 30190-00100, Nairobi, Kenya

    Isaac Cheruiyot

  4. Division of Orthopaedic Surgery, Department of Surgical Sciences Tygerberg Hospital, Tygerberg Hospital, Tygerberg, Private Bag, X3, Cape Town, 7505, South Africa

    Rudolph Venter

  5. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzińskiego 1, 30-705, Kraków, Poland

    Krzysztof A. Tomaszewski & Przemysław A. Pękala

  6. Scanmed St. Raphael Hospital, Adama Bochenka 12, 30-693, Kraków, Poland

    Krzysztof A. Tomaszewski

Authors
  1. Kerri Keet
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  2. Isaac Cheruiyot
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Contributions

KK: protocol/project development, data collection, manuscript writing/editing. IC: data analysis, manuscript writing/editing. RV, BMH, KAT and PAP: manuscript writing/editing.

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Correspondence to Kerri Keet.

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Keet, K., Cheruiyot, I., Venter, R. et al. A systematic review and meta-analysis of iliocapsularis muscle: an important landmark in orthopedic surgery. Surg Radiol Anat 43, 1999–2007 (2021). https://doi.org/10.1007/s00276-021-02815-5

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  • DOI: https://doi.org/10.1007/s00276-021-02815-5

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