The Hip Joint

Anatomy

From Arthroscopic hip surgeon.com

Dr Shaifaly Madan Rustagi

The Hip Joint

Ball-and-Socket
variety of synovial
joint
Articulation of the
head of the femur
with the acetabulum
of the hip bone
A fibrocartilaginous
ring called the
acetabular labrum
deepens the
acetabulum .

From Arthroscopic hip surgeon.com

The Acetabulum
The acetabulum
is formed by the
pubis, ischium
and ilium bones

The Joint Capsule

Anteriorly
proximally to the bone
surrounding the acetabulum.
Distally to the trochanteric line
Posteriorly
-to the margins of the acetabulum
and surrounding bone
-neck of the femur- not to the
trochanteric crest
Capsule has longitudinal and circular.

The circular fibers form a collar

around the femoral neck called the
zona orbicularis.
The longitudinal retinacular fibers
travel along the neck and carry
blood vessels.
grays from wikipedia

Ischiofemoral ligament
It arises from the
posteroinferior
margin of the
acetabular rim,
passes laterally to the
capsule and blends
with the circular
fibres of the capsule,
the zona orbicularis.
Posterior joint capsule
is reinforced by this
ligament.

Iliofemoral ligament or
ligament of Bigelow

It is the strongest
ligament in the human
body.
The apex is attached to the
lower half of the anterior
inferior iliac spine .
The base is attached to the
intertrochanteric line.
It is inverted Y or V
shaped. One limb goes to
the base of the greater
trochanter and the other to
the base of the lesser
trochanter.
It limits extension at the
hip joint.

Pubofemoral ligament
It is attached to the
superior ramus and
obturator crest of the
pubis superiorly and to
the base of the lesser
trochanter inferiorly.
It is inferior to the
iliofemoral ligament
and reinforces the
inferior part of the hip
joint capsule.
It also blends with the
medial parts of the
iliofemoral ligament

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The round
ligament or the
ligamentum teres
or the ligament of
head of femur

The round ligament of

the head of the femur
is attached to the
transverse acetabular
ligament and extends
to the fovea centralis
on the head of the
femur

Grays wikipedia

Synovial membrane
Lines
fibrous capsule
intracapsular
portion of neck of
femur
Acetabular labrum
Transverse ligament
Round ligament of
head of femur

Relations of hip joint

www.ganfyd.org

Blood supply
Medial
Circumflex
Lateral
Circumflex
Obturator
Inferior
gluteal

Nerves
Femoral (from nerve to rectus
femoris)
Obturator (anterior division)
Sciatic (articular twigs)
Nerve to quadratus femoris
Pain arising in hip joint may be
referred to the knee.

Movements
The hip joint is the most mobile
joint in the lower limb.
It is capable of flexion and
extension, abduction and
adduction, medial and lateral
rotation and all of these in a
circular motion- circumduction

Movements

In Adduction and
abduction- the femoral head
rotates in the acetabulum
about an anteroposterior axis.
Adduction is limited by contact
with the other leg, range is 30
degrees.
It is produced by the adductor
longus, brevis, magnus and the
gracilis and pectineus.
Abduction- is limited by
tension in the adductors and in
the pubofemoral
ligament.,range is 60 degrees.
It is brought about by the
gluteus medius and gluteus

Flexion-the head of femur

rotates about a transverse
axis that passes through
the acetabula .
It is limited by the thigh
touching the abdomen,
the range is 120 degrees.
It is mainly due to
contraction of the
iliopsoas muscle, with help
from the sartorius, rectus
femoris, and pectineus.
Extension- it is limited by
tension in the iliofemoral
ligament ,range is 20
degrees.
It is brought about chiefly
by the guteus maximus
muscles with help by the
hamstrings.

 Lateral rotation- by the

gluteus maximus,
quadratus femoris,
piriformis, obturator
internus and externus,
gemelli
Medial rotation- by the
anterior part of the
glueteus minimus and
medius and tensor fasciae
latae muscles
Range is about 40 degrees
for both the movements.

Applied anatomy
Head of
femur shifts
upwards.
Lurching gait
Tredlenburg
test is
positive

Perthes disease
Destruction
and
flattening of
head of
femur

Coxa vara and Coxa Valga

Fracture neck of femur

Displacement of greater
trochanter

Nelatons line and Bryants

triangle
- View of the
outer surface of
the bones of the
hip. showing
Roser-Nelaton
line (a d);
Bryant's triangle
(a b c - b c being
its base)
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