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HIP COMPLEX

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:

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HIP COMPLEX

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  1. HIP COMPLEX

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Angulations • Angle of inclination: Axis of femoral neck. Axis of femoral shaft. Angle value: Infant = 150 degrees. Adult = 125 degrees. Elderly = 120 degrees.

  12. Angulations • Angle of inclination: Pathologies: Increase = coxa valga. Decrease = coxa vara.

  13. Angulations • Angle of torsion: Transverse axis of femoral condyles. Axis of femoral neck. Angle value: 12 degrees (range = 8 – 25 degrees).

  14. Angulations • Angle of torsion: Pathologies: Increase = anteversion. Anterior surface of femur faces more medially. Decrease = retroversion. Anterior surface of femur faces more laterally.

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