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Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The hip is the most proximal joint of the lower extremity and has the greatest multiaxial range of motion of all the lower extremity joints. It is formed between the hip bone, which is part of the pelvis and consists of the ilium, ischium and pubis, and the femur, the long bone between the hip and the knee (Figure 12). The hip is a ball and socket joint (see joints) and, as such, makes the thigh and lower limb very mobile with respect to the pelvis. Because of its bony configuration, the joint is stabilized by both the cup-like acetabulum of the hip bone and the strong ligamentous attachments between it and the femur.
Single Best Answer Questions
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
A skydiver lands forcefully on his right lower limb and suffers a fracture of the acetabulum, with a dislocation of the femoral head into the pelvis. The acetabulum is formed by the ilium, ischium, and pubis. These three bones are completely fused by:Birth6 years of agePuberty16 years of age23 years of age
Advances in Hip Arthroscopy
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
At this location, the mechanical resistance of the labrum to traction (associated with instability) and compression (associated with FAI) is less compared to all the other regions. Functionally it acts as a sealant, enhances fluid lubrication and maintains synovial pressure and under negative pressure, it provides stability to the hip and prevents excessive contact pressure between the cartilages of the acetabulum and the femoral head. Acetabular labral tears are usually a consequence of bone deformity, FAI, trauma, degeneration, dysplasia, capsular laxity, instability and supraphysiological movements of the hip. It is believed that labral tears rarely occur in the absence of bony abnormalities. Labral lesions are associated with chondropathy, with delamination of the acetabular cartilage; the cartilage sheet appears like a wave when separated from the underlying bone, described as a wave sign (Fig. 12.7).
Desmoid fibromatosis presenting as lateral hip pain in an outpatient physical therapy clinic: A case report
Published in Physiotherapy Theory and Practice, 2023
Kelli Wrolstad, John J Mischke, Audrey RC Elias
The location of pain was not typical with that commonly seen in patients with acetabular labral tear since the vast majority of acetabular labrum tears are associated with anterior hip or groin pain (Cheatham, Enseki, and Kolber, 2016; Groh and Herrera, 2009; Reiman and Thorborg, 2014). In fact, Hamula et al. (2020) found only 6.7% of subjects with labral tears had pain isolated to the lateral hip region. Thus, the isolated lateral location of her hip pain that occasionally extended distally to the calf would be uncommon compared to the typical presentation of a labral tear. Labral tears commonly present with mechanical symptoms such as clicking, locking, catching, or giving way (Cheatham, Enseki, and Kolber, 2016; Groh and Herrera, 2009), none of which the patient had experienced. Patients with labral tears also frequently experience pain reproduction during combined passive flexion, adduction, and internal rotation due to increased strain on the labrum (Reiman, Mather, Hash, and Cook, 2014). The patient demonstrated restrictions in those motions, but also total loss of external rotation with a firm end-feel, which is not expected with a labral tear. Thus, the location of pain, limited external rotation, mechanism of injury, as well as the severe nature of her pain was inconsistent with a typical presentation of an acetabular labral lesion.
Recovery of Lower Extremity Function in the Initial Year Following Periacetabular Osteotomy: A Single Subject Analysis
Published in Physiotherapy Theory and Practice, 2022
Cailyn Schroeder, Linnea Zavala, Laura Opstedal, James Becker
Periacetabular osteotomy (PAO) is a hip preservation procedure used to correct hip dysplasia (Leunig, Siebenrock, and Ganz, 2001). In dysplastic hips, acetabular coverage of the femoral head is reduced, creating instability and altered weight bearing (Leunig and Ganz, 2007). This results in increased joint stress (Michaeli, Murphy, and Hipp, 1997) and is a contributing factor to the development of hip osteoarthritis (Jacobsen and Sonne-Holm, 2005; Reijman et al., 2005). In pre-osteoarthritic or young (<30 years) patients, PAO can be used to improve femoral head coverage and prolong the development of osteoarthritis (Ganz, Klaue, Son Vinh, and Mast, 1988; Leunig and Ganz, 2007; Millis, Murphy, and Poss, 1995; Steppacher, Tannast, Ganz, and Siebenrock, 2008). The most common PAO technique is the Bernese PAO during which the surgeon transects the pubic ramus freeing the acetabulum from the rest of the ilium, reorients the acetabular fragment to improve femoral head coverage and then screws the fragment in place (Ganz, Klaue, Son Vinh, and Mast, 1988). Bernese PAO has several advantages over other pelvic osteotomy techniques in that it maintains vascularization of the acetabular fragment, facilitates extensive acetabular reorientation, maintains the shape of the pelvic rim, and allows the posterior column of the pelvis to remain intact (Ganz, Klaue, Son Vinh, and Mast, 1988; Leunig and Ganz, 2007; Siebenrock, Leunig, and Ganz, 2001). This last factor means external fixation is not required and patients can begin weight bearing relatively soon after surgery.
Physical therapy management of a patient with persistent groin pain after total hip arthroplasty and iliopsoas tenotomy: a case report
Published in Physiotherapy Theory and Practice, 2022
With 310,800 procedures performed in 2010, total hip arthroplasty (THA) is one of the most common orthopedic surgeries in the United States (Wolford, Palso, and Bercovitz, 2015). It is also one of the most successful orthopedic surgeries, resulting in significant pain relief, improved quality of life, and increased mobility in the short and long term (Learmonth, Young, and Rorabeck, 2007). Complications occur in 2%-10% of THA cases, and the most common complication is aseptic loosening (36.5%) (Wetters et al., 2013). The next most common complications are dislocation (17.7%) and infections (15.3%) (Wetters et al., 2013). Iliopsoas impingement, hereafter referred to as hip impingement syndrome, is rare after THA, but it has been reported to occur in 4.4% of patients (Henderson and Lachiewicz, 2012; Lachiewicz and Kauk, 2009). Described etiologies of hip impingement syndrome after THA include an excessive prominence of the acetabular component at the anteroinferior rim, prominent surgical screws, and a prominent femoral collar (Dora, Houweling, Koch, and Sierra, 2007). Common symptoms of hip impingement syndrome include groin pain with active flexion of the hip and stretching of the iliopsoas (Lachiewicz and Kauk, 2009). Diagnosis of hip impingement syndrome typically involves a combination of clinical findings, imaging findings, and response to anesthetic injection (Dora, Houweling, Koch, and Sierra, 2007).