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Layered Concept of the Hip and Pelvis

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Providing appropriate care to young patients and athletes with hip pain is predicated upon a thorough and comprehensive diagnostic evaluation. A comprehensive approach to the evaluation of such a patient is paramount to successfully defining the source of the patient’s symptoms and ultimately rendering appropriate treatment. Compartmentalization of the normal hip anatomy into layers from deep to superficial allows for a comprehensive and systematic evaluation and identification of all potential pain generators in patients with either hip or groin pain. This chapter will discuss a layered approach to the evaluation of the painful groin in a manner that allows the clinician to narrow the differential diagnosis of “hip” pain. The four layers are (1) the osteochondral layer, (2) the inert layer, (3) the contractile layer, and (4) the neurokinetic layer. The normal anatomy of each layer will be reviewed with attention paid to structure and function. The most common pathologic conditions affecting the young patient with hip pain will also be reviewed, with an emphasis on the interaction between the layers.

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Author information

Authors and Affiliations

  1. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA

    Alexander E. Weber & James R. Ross

  2. Department of Orthopaedic Surgery, Center for Hip Preservation Surgery, Hospital for Special Surgery, 10021, New York, NY, USA

    Bryan T. Kelly

  3. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

Authors
  1. Alexander E. Weber
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  2. James R. Ross
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  3. Bryan T. Kelly
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  4. Asheesh Bedi
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Corresponding author

Correspondence to Asheesh Bedi .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

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Weber, A.E., Ross, J.R., Kelly, B.T., Bedi, A. (2015). Layered Concept of the Hip and Pelvis. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_10

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  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_10

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  • Print ISBN: 978-1-4614-6964-3

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