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The iliocapsularis muscle is a deep hip flexor that has been largely overlooked in the literature. It is a constant muscle, distinct from the iliacus, that overlies the anteromedial hip capsule. The muscle is supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins. Its function is not yet fully understood, but it is believed to play a role in stabilising the hip joint.
| Characteristics | Values |
|---|---|
| Muscle Name | Iliocapsularis (IC) |
| Muscle Group | Hip |
| Muscle Type | Deep hip flexor |
| Muscle Origin | Inferior border of the anterior-inferior iliac spine (AIIS) |
| Muscle Insertion | Just distal to the lesser trochanter (LT) |
| Blood Supply | Femoral nerve, lateral circumflex femoral artery, profunda femoral artery (branch of femoral artery), deep femoral arteries and veins |
| Muscle Fibre Direction | Superolateral to inferomedial |
| Mean Length | 116.8 ± 11.2 mm |
| Mean Width | 12.8 ± 3.1 mm |
| Function | May stabilise the hip joint, prevent subspine impingement, and reduce capsular impingement during walking and hip flexion |
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What You'll Learn
Iliocapsularis is a distinct muscle
The iliocapsularis muscle (IC) is a distinct and consistent muscle that lies beneath the rectus femoris and to the lateral right of the iliacus. It is a deep hip flexor that overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty.
The IC originates from the inferior border of the anterior inferior iliac spine (AIIS) and the anterior hip capsule. Its insertion is located just distal to the lesser trochanter. The IC is supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins. The muscle fibre direction is from superolateral to inferomedial.
The IC is believed to play a role in stabilising the hip joint by tensing the anterior capsule during walking and hip flexion. This helps to prevent pinching of the anteromedial part of the capsule between the femoral head and the acetabulum. The IC is also thought to contribute to the formation of new osteophytes when a mechanical load is applied through the AIIS, which could be a potential cause of subspine impingement.
The IC was previously believed to be part of the iliacus, and it still does not appear in all anatomical texts. However, it is relevant to orthopaedic surgeons and physical rehabilitation specialists, particularly in the context of postoperative patient care. The true function of the IC is yet to be fully understood.
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Its role in hip arthroplasty
The iliocapsularis muscle (IC) is a constant muscle that lies beneath the rectus femoris and to the lateral right of the iliacus. It is an important landmark in anterior approaches to hip arthroplasty.
The IC overlies the anteromedial hip capsule and is believed to play a role in stabilising the hip joint. An electromyography study showed that the IC may stabilise the hip joint by tensing the anterior capsule during walking. It is also thought to prevent pinching of the anteromedial part of the capsule between the femoral head and the acetabulum.
The IC is also relevant in the context of hip pathology and surgery. It is an important landmark for exposure of the anteromedial hip capsule and psoas tendon interval during the Bernese pericapsular osteotomy. The contraction of this muscle can theoretically tighten the anterior hip capsule, helping to stabilise the femoral head within a dysplastic acetabulum.
Anatomical studies have also investigated the relationship between the IC and the inferior iliofemoral ligament (ILFL) in total hip arthroplasty. The preservation of soft tissues, including the IC and ILFL, is important for preventing dislocation after total hip arthroplasty. The IC and ILFL are located at the anterolateral side of the femoral head, and the ICM can serve as a landmark for preserving the ILFL in total hip arthroplasty using the anterior approach.
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Its origin and insertion
The iliocapsularis muscle is a deep hip flexor that was previously believed to be part of the iliacus. It is also sometimes referred to as the iliacus minor, ilioinfratrochantericus, or accessory iliacus. However, it is a distinct and consistent anatomical structure.
The iliocapsularis overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty. It originates from the inferior border of the anterior inferior iliac spine (AIIS) and the anterior hip capsule. The main origin arises from an elongated attachment to the anteromedial hip capsule.
The insertion of the iliocapsularis is located just distal to the lesser trochanter. In 54 muscles (71%), the insertion was found to be 20 mm distal to the lesser trochanter. The muscle is supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins.
The mean length of the iliocapsularis muscle was found to be 116.8 ± 11.2 mm, with a width of 12.8 ± 3.1 mm. There were no significant differences in length or width between sides, sex, and age. The muscle fibre direction was found to be from superolateral to inferomedial.
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Iliocapsularis's blood supply
The iliocapsularis (IC) is a constant muscle that is distinct from the iliacus. It overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty. The IC originates from the anterior-inferior iliac spine (AIIS) and the anterior hip capsule. Its insertion is located just distal to the lesser trochanter.
The IC muscle receives its blood supply from a dual source. It is supplied by branches from the lateral circumflex femoral artery and vein, which penetrate the lateral border. Additionally, small branches from the deep femoral artery and vein traverse the iliacus and then penetrate the medial border of the distal portion of the IC.
The IC is also innervated by a thin branch of the femoral nerve, specifically the L2-4 root. This nerve branch first penetrates the iliacus before emerging between the iliacus and IC to supply the muscle.
The IC muscle is thought to play a role in stabilizing the hip joint by tensing the anterior capsule during walking. This helps to prevent pinching of the anteromedial part of the capsule between the femoral head and acetabulum. The IC is relevant to orthopaedic surgeons and physical rehabilitation specialists, especially in postoperative patient care.
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Its importance in stabilising the hip joint
The iliocapsularis (IC) is a small, deep hip flexor muscle that lies beneath the rectus femoris and to the lateral right of the iliacus. It is an important landmark in anterior approaches to hip arthroplasty, particularly in patients with symptomatic dysplastic hips.
The IC overlies the anteromedial hip capsule and is believed to play a role in stabilising the hip joint. An electromyography study by Lawrenson et al. (2019) found that the IC may stabilise the hip joint by tensing the anterior capsule during walking and hip flexion. This prevents pinching of the anteromedial part of the capsule between the femoral head and the acetabulum.
The IC's role in stabilisation is further supported by its strong attachment to the anterior capsule, which suggests that it contributes to the tensioning of the capsule and, consequently, the stability of the hip joint. This is particularly relevant in individuals with acetabular dysplasia, where hypertrophy of the IC is observed. The increased size of the IC in these cases is interpreted as a positive adaptation to compensate for deficient bony stability mechanisms.
Additionally, the IC to rectus femoris ratio has been found to be indicative of instability in borderline hips. This suggests that the IC plays a crucial role in maintaining hip stability, and any alterations in its size or function can have implications for overall hip joint stability.
While the IC's true function remains unknown, its anatomical characteristics and attachments indicate its importance in stabilising the hip joint. Its role in hip pathology and function is an area of increasing interest and further research.
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Frequently asked questions
The iliocapsularis muscle (IC) is a constant muscle that overlies the anteromedial hip capsule. It is an important landmark in anterior approaches to hip arthroplasty.
The iliocapsularis muscle originates from the inferior border of the anterior inferior iliac spine (AIIS) and the anterior hip capsule.
The iliocapsularis muscle inserts just distal to the lesser trochanter.
The exact function of the iliocapsularis muscle is still unknown. However, it is believed to play a role in stabilizing the hip joint by tensing the anterior capsule during walking and hip flexion.
