Non Muscular Anatomy Hip

Hip Joint Articulation between head of femur and acetabulum Synovial ball and socket joint Transmits weight from trunk to lower limb Acetabulum faces laterally, anteriorly and inferiorly Femoral head faces medially, anteriorly and superiorly Anterior part of the femoral head articulates with the joint capsule Acetabulum missing inferiorly forming the “acetabular notch” Acetabular fossa forms the non-articulating part of the acetabulum

Hip - Ligaments Iliofemoral ligament ASIS and rim of acetabulum, passes obliquely downwards and lateral to the intertrochanteric line on the anterior femoral head Very strong and think Closely connected to the joint capsule Y shaped Split into two bands Anterior to the joint

Hip - Ligaments Pubofemoral ligament From the obturator crest and the superior ramus of the pubis to the inferior capsule and iliofemoral ligament Strengthens the inferior and anterior aspects of the joint capsule Merges with the inferior band of the iliofemoral ligament

Hip - Ligaments Ischiofemoral ligament From the ischium and acetabulum merging with the capsule posteriorly attaching into the intertrochanteric line of the femur Spiral ligament Attaches onto the superior femoral neck and greater trochanter More posterior

Hip – Ligaments – Restraints to Motion

Hip – Joint Capsule and Synovial Membrane Fibrous capsule is very strong Surrounds the acetabulum and attaches onto the intertrochanteric line of the neck of the femur Gluteus minimus tendon inserts into the capsule Synovial membrane lines the internal surface of the capsule Arises from the acetabular labrum and tranverse ligament to the fovea capitis Anterior capsule communicates with the psoas bursa

Hip – Extracapsular Structures Transverse ligament of the acetabulum Completes the inferior decificieny of the acetabular rim Creates a foramen with the acetabular notch Vessels and nerves pass through the foramen Acetabular labrum Fibrocartilaginous ring around the acetabulum and transverse ligament Deepens the hip joint increasing joint stability Acts as a shock absorber Decreases the force transmitted to the articular cartilage by increasing the surface area of the acetabulum Provides a seal for the joint to maintain synovial fluid and pressure

Hip – Intracapsular Structures Ligamentum teres Weak flattened band of connective tissue Attaches from the adjacent margins of the acetabular notch and the lower border of the transverse ligament and then inserts onto the fovea capitis on the head of the femur Enclosed in a sleeve of synovial membrane Therefore intracapsular but extrasynovial Role of this ligament is unknown as its too weak to provide stability and often not present

Hip Capsular Pattern Resting Position Close Packed Position Flexion, abduction and internal rotation (order varies) Resting Position 30° Flexion, 30° Abduction, 20° External Rotation Close Packed Position End range extension, internal rotation and abduction

Hip - Arthrokinematics

Hip - Arthrokinematics

Hip - Arthrokinematics