The Hip Joint

Anatomy

From Arthroscopic hip surgeon.com

 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
deepens thelabrum From Arthroscopic hip surgeon.com
acetabulum .
 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 Healthfavo.com
medial parts of the
iliofemoral ligament
 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
Circumfle
x
• Lateral
Circumfle
x
• 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.
 Movement
The hip joint iss 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

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 minimus
Movement
•
s
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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