Transcript The Hip Joint

The Hip Joint
Type: Synovial (Ball & Socket)
Articular Surfaces: head of femur & acetabulum
Articular surfaces: 1- Acetabulum has:
- C- shaped articular surface = lunate surface, Acetabular fossa,
Acetabular notch -----► converted into acetabular foramen by transverse ligament of the acetabulum
- Labrum acetabulare deepens the acetabular cavity. 2- Head of femur -
Capsule & Synovial Membrane:
Ligaments:
1- Ilio-femoral lig.: Y- shaped,
strong, attached between
AIIS and both ends of
trochantric line. Prevents
hyper-extension.
2- Pubo-femoral lig.:Triangular
in shape, supports the
inferomedial part of the
joint, attached between iliopubic eminence and the
capsule. Prevents hyperabduction.
3- Iscio-femoral lig.: from
ischium to the back of the
capsule. It becomes tense in
medial rotation.
4- round ligament of the head
of femur: Inside the joint,
between head of femur to
acetabular notch and
transverse lig., carries blood
supply to head of femur.
Movements:
1- Flexion: Psoas major, Iliacus
+ Rectus femoris, sartorius, pectineus.
2- Extension: Gluteus maximus + hamstring
3- Abduction: Gluteus medius & minimus + tensor fascia latae
4- Adduction: Adductor longus, brevis, magnus
+ gracilis, pectineus
5- Medial rotation: Gluteus medius & minimus + tensor fascia
latae
6- Lateral rotation: The 6 lateral rotators: Obturator internus, 2
gemelli, piriformis, obturator externus,
quadratus femoris + gluteus maximus, adductors.
7- Circumduction:
Nerve supply of hip joint:
1- Femoral nerve.
3- sciatic nerve.
2- Obturator nerve.
4- Nerve to quadratus femoris.
Relations of the hip joint:

Anteriorly:
Pectineus, Iliopsoas, RF
(straight head), femoral
vessels.

Laterally:
Tensor fascia latae, gluteus
minimus & medius.

Posteriorly:
Piriformis, obturator internus, 2
gemelli, quadratus femoris,
sciatic nerve.

Above:
RF (reflected head), gluteus
minimus.

Below:
Obturator externus.
Stability of the hip joint:
The hip joint is very stable joint due to:
1- The head of femur fits accurately to the acetablum.
2- The three strong ligaments outside the capsule.
3- The surrounding strong muscles.
Hip dislocation is usually posterior as in car accidents. It
occurs with no fracture of the acetabulum (if the hip is
flexed and adducted) or with fracture acetabulum (if the
hip is flexed and abducted). The sciatic nerve may be
injured in posterior hip dislocation.
Blood supply to the head of femur:
Blood supply to acetabular fossa and
ligament of the head of femur:
X-Ray of the hip joint:
MRI of the hip joint: