1. HIP COMPLEX

2. Review Bony Articular Surfaces Synovial ball and socket joint: Synovial ball and socket joint: Femoral head. Acetabular fossa. Lunate surface. Arranged to favor stability over mobility. Arranged to favor stability over mobility. Three degrees of freedom. Three degrees of freedom.

3. Sciatic Notches Separated from each other by ischial spine. 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: Acetabular labrum:Fibrocartilage. Deepens acetabular socket. Grips head of femur. Transverse acetabular ligament: 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. Fibrous capsule of joint is tight. Encloses head and most of femoral neck. Encloses head and most of femoral neck. Proximal attachment: Proximal attachment: Acetabulum and transverse acetabular ligament. Distal attachment: Distal attachment: Greater trochanter and intertrochanteric line.

6. Joint Capsule and Ligaments Iliofemoral ligament: 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: 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: 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: Ligamentum teres: Proximal attachment: Fovea of femoral head. Distal attachment: Transverse acetabular ligament. Supports artery to the head of the femur. Zona orbicularis: Zona orbicularis: A collar-like ligament around the distal neck of the femur.

10. Blood and Nerve Supply Nerve supply: Nerve supply: Mostly supplied by branches of the: Femoral nerve. Obturator nerve. Blood supply: Blood supply: Superior and inferior gluteal arteries. Medial and lateral femoral circumflex arteries. Obturator arteries.

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

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

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