Anatomy of Hip joint

1. HIP JOINT

2. It is the joint of lower limb
Type:
 Synovial
 Polyaxial
 Ball and socket

3. Stability depends upon:
 Depth of acetabulum
 Narrowing of the mouth of acetabulum
 Tension & strength of the ligaments
 Strength of the surrounding muscles
 Length and obliquity of neck of femur
 Atmospheric pressure
 *A wide range of mobility is possible because of long neck
of femur.It is narrower than the diameter of head of femur

5.  Lunate surface of
acetabulum
 Head of femur

6.  Fibrous capsule
 Synovial membrane
 Labrum acetabulare
 Ilio femoral ligament
 Pubo femoral ligament
 Ischio femoral ligament
 Transverse acetabular ligament
 Ligament of head of femur

8.  Parts:
 Capsule is made of:
 Outer longitudinal fibres (the part reflected along
neck of femur to form retinacula) – blood vessels of
head & neck of femur pass along retinacula.
 Inner circular fibres (zona orbicularis)
 Features:
 Thicker –anteriorly-subjected to maximum tension
in standing posture
 Thinner – postero inferiorly

17. Other names:
 Ligamentum teres/
Round ligament of
head of femur
 Rounded- above
 Wider -below
 Above- pit of fovea
 Below –transverse
acetabular ligament

22. Superior :
 Reflected head of
rectus femoris
 Gluteus medius &
minimus
 Part of gluteus
maximus
Inferior:
 pectineus
 Obturator externus
 Gracilis
 Adductor longus,brevis
magnus
 hamstrings

23. Branches of :
 obturator artery
 Medial & lateral circumflex femoral arteries
 Supr.& infr.gluteal arteries
 Retinacular arteries supply head & neck of
femur

25.  Femoral nerve through nerve to rectus
femoris
 Anterior division of obturator nerve
 Nerve to quadratus femoris
 Superior gluteal nerve

26.  Flexion
 Extension
 Abduction
 Adduction
 Circumduction
 Flexion is limited by contact of thigh with
antr.abdominal wall
 Adduction is limited by contact with opposite limb

27.  Extension -15 degrees
 Abduction -50 degrees
 Medial rotation -25 degrees
 Lateral rotation-60 degrees

28. Flexion:
 Psoas major
 Iliacus,assisted by-
 Pectineus,rectus
femoris,sartorius adductor
longus
Extension:
 Gluteus maximus &
hamstrings assisted by
tensor fascia lata
Adduction:
 Adductor longus,brevis,magnus
 Assisted by pectineus ,gracilis
Abduction:
 Gluteus medius & minimus
 Assisted by tensor fascia lata &
sartorius
Medial rotation:
gluteus medius,gluteus minimus
Lateral rotation:
 Obturator
internus,externus,piriformis,
 2 gamelli,quadratus femoris

29.  Hip joint is commonly affected by disease
or by injuries

30.  Congenital or acquired
 Congenital – due to non development of
upper part of acetabulum
 Dislocation is more common posteriorly and
less common anteriorly.
 In posterior dislocation ,sciatic nerve may be
injured

32.  Flattening of head of femur
 X - rays reveal joint space is increased

34.  Neck-shaft angle is reduced from normal
angle
 Normal angle is 125 degrees

35.  Disease of old age
 Due to growth of osteophytes at the
articular surfaces
 Movements are limited and painful

40.  Nelaton’s line:
 Line joining anterior superior iliac spine to
ischial tuberosity
 It passes through highest part of greater
trochanter

41.  Mainly tuberculosis
 In any disease , referred pain is felt in the
knee due to common nerve supply

42.  Below 5 years - congenital dislocation and
tuberculosis
 5 -10 years -Perthe’s disease
 10 –20 years – Coxa vera
 above 40 years -Osteoarthritis