Anatomy

Biomechanics of the Hip

James C. Iatridis
Adapted from
Nordin & Frankel text

Hip Anatomy Hip Anatomy 2

• A ball and socket joint • Femoral head
– Loose joint capsule surrounded by large, strong muscles
– Wide range of motion
– Forms 2/3 of a sphere
• Required precise alignment and control – Cartilage is thickest on
– Acetabulum medial-central surface
• Concave component (socket) of hip and thinnest at
• Cartilage is thickest peripherally
periphery
• Radius of curvature of unloaded acetabulum is smaller than femoral
head, it undergoes elastic deformation under loading to become
congruous.
– Labrum
• Acetabular cavity is deepened by the labrum and the transverse
acetabular ligament
• A flat rim of fibrocartilage

Hip contact pattern Femoral Neck

• Fuji-film pattern of contact • Two angular relationships
– Unchanged after removel of transverse acetabular between the femoral neck
ligament, or labrum, or both and shaft
First:
– Angle of inclination of neck
to shaft in frontal plane
– Normal is ~ 125 deg
– Alterations in this angle
affects force transmission
and alters lever arm

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 Femoral Neck Femoral Neck
• Second angle: • Joint reaction force
• Angle of inclination in parallels the
transverse plane trabeculae of the
(angle of anteversion) medial system
– Normal ~ 12 deg with demonstrates its role
fairly large variation in supporting this
– <12 degrees is force
retroversion
– > 12 degrees is
anteversion

Femoral Neck Radiograph

• Epiphyseal plates are
• Can see trabecular
at right angles to
system in medial and
trabeculae and are
lateral regions
perpendicular to joint
reaction force
– Thought to resist
compressive forces on
femoral head by
contraction of abductor
muscles

Aging and Movements of hip: Definition of

degeneration rotations
• With aging
– Cortical bone is
thinned and
cancellated
– Trabeculae are
gradually resorbed
– May predispose to
fracture

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 Range of motion Range of motion during gait
• Range of motion during
activities of daily living
(ADL)

Aging and gait Surface joint motion of hip

• Range of motion • Gliding of femoral head on acetabulum
decreases with aging • Center of rotation is normally estimated at the
• Gait shown for older center of the femoral head
(left) and younger • If incongruity is present, gliding may not be
men (right) at instant parallel or tangential to joint surface and
of heel strike. cartilage may be abnormally compressed or
distracted
– Differences in hip
flexion, flexion of • Instant center analysis cannot be performed
ankle, and heel-to- accurately using a planar x-rays since rotation
floor angle of both feet occurs in 3 planes simultaneously.

Statics Statics
Black line is plumb line
which shows shift of
• When a person changes from standing on 2 line of gravity (and
legs to a single leg, the line of gravity of body hence lever arm) with
different positions of
shifts in all 3 planes. upper body with:
• Moments must be developed to counteract A) Pelvis in neutral
this, generating muscle forces and increasing position
B) Shoulders tilted
joint forces toward supporting hip
C) Shoulders away from
supporting hip
D) Pelvis rotated away
from supporting hip

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 Joint force calculation: free-body Joint force calculation: equilibrium
technique method 1
• Single-leg stance with • External forces during
pelvis in neutral position
single-leg stance
• 3 main co-planar forces:
– Ground reaction force (W) – Gravitational force of
– Abductor muscles force (A) stance leg is 1/6 W
– Joint reaction force (J) based on
• Geometries determined anthropometric
from x-ray and known assumptions
muscle insertion sites – Remaining force is
• Calculation magnitudes equal to 5/6 W
based on geometric
angles

Joint force calculation: equilibrium Joint force calculation: equilibrium

method 2 method 3
• Internal forces acting on hip • Abductor force calculation
– Sum of moments equation • A=2W
• Moment due to abductor force (A) and due to gravity force
at center of mass (5/6*W) and 2 associated moment arms • 30 degrees direction from x-ray
• Q is center of rotation of hip joint – vertical and horizontal components

Joint force calculation: equilibrium Joint force calculation: equilibrium

method 4 method 5
• Joint forces can be • Sum of forces in x and y
calculated from a lower free- directions can be determined
body diagram from equilibrium
• Forces acting on femur are
– Abductor muscle (A)
– Weight of leg (1/6 W)
– Ground reaction force (W)
– Q is center of rotation

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 Joint force calculation: equilibrium
Abductor muscle force
method 6
• Solve for joint reaction • Strong effect of
forces and direction moment arms
(muscle force lever
• Result: J=2.7W and acts at arm (c) and
an angle of 69deg from gravitational force
horizontal arm (b) on muscle
forces
• Particularly relevant
for pathology, and
implantation of total
hip replacements

Hip joint reaction forces from

Hip joint reaction force during gait
• Hip joint force for men
and women as a function
of gait cycle.
• Similar patterns but
women have lower
magnitude
– Wider female pelvis
– Difference in inclination of
femoral neck to shaft angle
– Differences in gait pattern
instrumented prosthesis
• Joint reaction force
always greater than
force on ground
• Joint force relative to
ground reaction force
increased with
walking speed

Range of hip joint forces Hip joint forces

• Hip joint forces range
from 2-8XBW during 8xBW 3.4xBW 2.2xBW
walking
• Stair
ascending/descending
yields loads from 2.6-
5.5xBW
• Highest hip forces occur
during
– Stair climbing
– Getting up from low chair

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 Future directions
• Spine biomechanics