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jlee96
05-08-2002, 10:17 AM
In the modeling of stresses in the femur and micromotion of hip implants,
the inclusion of the abductors and abductors/gluteus maximus seems to be
essential for walking and stair-climbing. The issue of dispute lies in the
inclusion of the iliotibial band (ITB).

Numerous studies model the ITB with an attachment at the greater trochanter
or, alternatively, with no contact with the femur at all, both of which are
not physiologically correct; the ITB rounds the greater trochanter without
attaching to it. Most studies leave the ITB out altogether, based on John
Charnley’s comment that contraction of either the gluteus maximus or the
tensor fascia lata will make the ITB slack at the greater trochanter.

The questions I would like to resolve are the following:

1. Is Charnley correct for walking and stair-climbing, or does his
observation only apply to the one-legged stance (if at all)?

2. If the ITB is NOT slack, should it be included in mechanical simulation
of walking and stair-climbing, or is its contribution insignificant?

3. Have there been any mechanical simulations with the ITB rounding the
greater trochanter?

I have a copy of Luca Cristofolini’s article, A Critical Analysis of Stress
Shielding Evaluation of Hip Prostheses, Critical Reviews in Biomedical
Engineering, 25(4&5):409-483(1997). This excellent article, in its
thoroughness, has covered articles on the matter up to 1997. Any references
past that date will be appreciated.

Thank you,
Jessica Lee
University of Southern California
Candidate for Master of Science in Biomechanics


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