A power point of gross anatomy and applied anatomy of hip joint

1. The Hip Joint
Anatomy
From Arthroscopic hip surgeon.com
Dr Shaifaly Madan Rustagi

2. 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

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

5. 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

6. 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.

7. 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.

8. 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
Healthfavo.com

9. 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

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

11. Relations of hip joint
www.ganfyd.org

12. Blood supply
• Medial
Circumflex
• Lateral
Circumflex
• Obturator
• Inferior gluteal

13. 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.

14. 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

15. Movements
• 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.
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

16. • 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.

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

18. Perthes disease
Destruction and
flattening of
head of femur

19. Coxa vara and Coxa Valga

20. Fracture neck of femur

22. Displacement of greater trochanter

23. 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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