HIP COMPLEX

Review Bony Articular Surfaces  Synovial ball and socket joint: Femoral head.

Acetabular fossa.

Lunate surface.

 Arranged to favor stability over mobility.

 Three degrees of freedom.

Sciatic Notches  Separated from each other by ischial spine.

Ligaments: Sacrospinous.

Sacrotuberous.

Convert notches into foramina: Greater sciatic foramen for structures entering or leaving pelvis.

Lesser sciatic foramen for structures entering or leaving the perineum.

Joint Capsule and Ligaments  Acetabular labrum: Fibrocartilage.

Deepens acetabular socket.

Grips head of femur.

 Transverse acetabular ligament: Continuation of acetabular labrum across acetabular notch.

Converts notch into a foramen for the transmission of the artery to the head of the femur.

Joint Capsule and Ligaments  Fibrous capsule of joint is tight.

 Encloses head and most of femoral neck.

 Proximal attachment: Acetabulum and transverse acetabular ligament.

 Distal attachment: Greater trochanter and intertrochanteric line.

Joint Capsule and Ligaments  Iliofemoral ligament: Strongest and most important ligament of the hip joint.

Called the “Y” ligament of Bigelow.

Proximal attachment: Anterior inferior iliac spine.

Distal attachment: Intertrochanteric line.

Resists hyperextension of the hip.

Joint Capsule and Ligaments  Pubofemoral ligament: Proximal attachment: Pubis near inferior rim of acetabulum.

Distal attachment: Neck of femur above lesser trochanter.

Resists hyperextension of the hip.

Joint Capsule and Ligaments  Ischiofemoral ligament: Proximal attachment: Ischium near posterior rim of acetabulum.

Distal attachment: Neck of femur medial to greater trochanter.

Resists hyperextension of the hip.

Joint Capsule and Ligaments  Ligamentum teres: Proximal attachment: Fovea of femoral head.

Distal attachment: Transverse acetabular ligament.

Supports artery to the head of the femur.

 Zona orbicularis: A collar-like ligament around the distal neck of the femur.

Blood and Nerve Supply  Nerve supply: Mostly supplied by branches of the: Femoral nerve.

Obturator nerve.

 Blood supply: Superior and inferior gluteal arteries.

Medial and lateral femoral circumflex arteries.

Obturator arteries.

Angulations  Angle of inclination: Axis of femoral neck.

Axis of femoral shaft.

Angle value: Infant = Adult = Elderly = 150 degrees.

125 degrees.

120 degrees.

Angulations  Angle of inclination: Pathologies: Increase = coxa valga.

Decrease = coxa vara.

Angulations  Angle of torsion: Transverse axis of femoral condyles.

Axis of femoral neck.

Angle value: 12 degrees (range = 8 – 25 degrees).

Angulations  Angle of torsion: Pathologies: Increase = anteversion.

Anterior surface of femur faces more medially.

Decrease = retroversion.

Anterior surface of femur faces more laterally.