Transcript HIP COMPLEX - University of Kansas Medical Center

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.