Lecture Notes: Anatomy and Function of the Hip Joint

Introduction

• The course started in August, covering the foot, ankle, lower limb, knee, and now the hip.
• The final topic will be the pelvis.
• Focus is on assessing joints and pathologies related to the hip.

Overview of the Hip Joint

• The hip is the largest and most stable joint in the body.
  • Injuries are often immediately perceptible during activities like walking or running.
• The hip joint is a multi-axial ball and socket joint with deep articulation.
  • Formed by the femoral head (convex) and the acetabulum (concave).

Anatomy of the Hip Joint

• Femoral Acetabular Joint

  • Also known as the coxofemoral joint.
  • Composed of the femoral head and acetabulum.
  • Acetabulum is formed by three pelvic bones: ilium, ischium, and pubis.
  • The acetabulum is deepened by a fibrocartilaginous collar (labrum).

• Femur

  • Largest bone in the body.
  • Important structures: greater trochanter, lesser trochanter, neck, and head.
  • Common site for fractures, especially in the elderly or malnourished.

Ligamentous Support

• Major Ligaments
  • Iliofemoral Ligament: Prevents hyperextension; strongest ligament.
  • Pubofemoral Ligament: Limits abduction and extension.
  • Ischiofemoral Ligament: Provides stability, prevents hyperextension.
• Ligamentum Teres: Provides stability, particularly during flexion and abduction.

Muscular Anatomy

• Anterior Muscles
  • Rectus Femoris, Sartorius, Iliopsoas group (hip flexors).
• Medial Muscles
  • Adductor group, Gracilis (adductors and internal rotators).
• Lateral and Posterior Muscles
  • Gluteus Medius, Tensor Fasciae Latae (abductors), Gluteus Maximus, Hamstrings (extensors).
• Intrinsic Muscles
  • Piriformis, Gemelli, Obturator Internus, Quadratus Femoris (control internal rotation).

Special Notes on the Gluteus Medius

• Functions in multiple planes (sagittal, frontal, transverse).
• Important for stabilizing the pelvis.

Clinical Anatomy

• Femoral Triangle

  • Formed by inguinal ligament, sartorius, and adductor longus.
  • Contains femoral vein, artery, and nerve.

• Bursae

  • Trochanteric, Iliopsoas, Ischial gluteal bursae to reduce friction.

• Neurovascular Anatomy

  • Femoral nerve, obturator nerve, and sciatic nerve.
  • Blood supply via medial and lateral femoral circumflex arteries and obturator artery.

Hip Function and Motion

• Primary function: Transfer force from lower extremity to the spine.
• Force exerted on the hip is greatest during running.
• Motions include flexion, extension, abduction, adduction, internal/external rotation, each driven by specific muscle groups.

Study Tips

• Focus on understanding the joint's anatomy, ligaments, and supporting structures.
• Be familiar with the muscles and their functions during various hip movements.

This concludes the current part of the lecture. The next section will cover inspection and observation of the hip.