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Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The hip is a very stable joint, with stability provided by the ball and socket configuration of the femur and pelvic bones and several thick and strong ligaments (Figure 13). There are three ligaments external to the hip joint: the iliofemoral, ischiofemoral, and pubofemoral ligaments. They are named according to the parts of the hip bone that they are attached to, plus their attachment to the femur. There are two more ligaments at the hip inside the ball and socket of the joint: the ligamentum teres (ligament of the head of the femur) and the transverse acetabular ligament. The ligamentum teres directly attaches the head of the femur to the acetabulum of the hip bone. There is a small pit in the smooth head of the femur, the fovea, where the ligament attaches. Similarly, the other end of the ligament attaches to the centre of the acetabular fossa, where it is surrounded by the smooth lunate surface of the acetabulum. This internal hip joint ligament prevents the head of the femur from rotating too far in any direction within the acetabulum. The transverse acetabular ligament helps to make the socket of the hip joint deeper, along with the acetabular labrum, a rim of fibrocartilage around the edge of the acetabulum. The ligament crosses the acetabular notch, part of the rim not extended by the labrum, making a complete ring of soft tissue. As a result of this extension of the acetabulum, more than half of the femoral head fits within the socket of the hip joint.
Arthroscopic hip preservation surgery
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Femoroacetabular impingement, acetabular labrum, and articular cartilage pathology constitute the majority of the conditions that can be managed preserving the hip joint. The acetabular labrum is a fibrocartilaginous tissue attached to the rim of the acetabulum and continues as the transverse acetabular ligament inferiorly bridging the cotyloid fossa. The labrum increases the depth, surface area, volume, congruity, and stability of the hip joint. The labrum adds 33% to the acetabular volume and contributes an average of 22% to articulating surface area.3 It provides a seal around the osseous acetabulum and femoral head. This fluid seal produces a negative intra-articular pressure, significantly adding to hip joint stability.4
Hip and knee
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The hip is a ball and socket joint formed by the head of the femur and the cup-shaped acetabulum (Latin: little vinegar cup) (Figure35.1). The joint allows a considerable range of movement in different planes, and is still inherently stable because of its bony anatomy and the static and dynamic stabilisers. The static stabilisers are composed of the ligaments (iliofemoral and pubofemoral ligaments anteriorly and the ischiofemoral ligament posteriorly), the joint capsule and the labrum. The muscles running across the joint (short external rotator muscles posteriorly, the iliopsoas anteriorly and the hip abductors laterally) constitute the dynamic stabilisers. The acetabular labrum is a fibrocartilagenous structure that is triangular in cross-section and attaches to the rim of the acetabulum except at its base, where it is replaced by the transverse ligament. It helps in deepening the socket, thereby enhancing stability. It also acts as a fluid seal and thereby helps to improve joint lubrication.The femoral head derives its blood supply mainly from the retinacular branches of the medial circumflex femoral artery and there is a small contribution from the artery of the ligamentum teres.
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.
Rapid decline of yearly number of hip arthroscopies in Sweden: a retrospective time series of 6,105 hip arthroscopies based on a national patient data register
Published in Acta Orthopaedica, 2021
Tobias Wörner, Frida Eek, Jesper Kraus-Schmitz, Mikael Sansone, Anders Stålman
Hip arthroscopy was long deemed impossible due to anatomic constraints. Easier arthroscopic access to knee and shoulder joints led to an increasing arthroscopy rate in these joints during the 1990s and 2000s (Kim et al. 2011, Colvin et al. 2012a). During the 1990s, improved surgical equipment and techniques enabled surgeons to gain easier access to the hip joint for diagnosis and treatment of a variety of pathologies (Griffiths and Khanduja 2012), including femoroacetabular impingement syndrome (FAIS), acetabular labrum tears, and chondral lesions (Bedi et al. 2013). Arthroscopic hip surgery has been one of the fastest emerging fields within orthopedics and might be at a tipping point for even wider use (Khan et al. 2016a).
Musculoskeletal models with generic and subject-specific geometry estimate different joint biomechanics in dysplastic hips
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Ke Song, Andrew E. Anderson, Jeffrey A. Weiss, Michael D. Harris
Developmental dysplasia of the hip (DDH) is a structural disease characterized by a shallow acetabulum, insufficient femoral coverage, and abnormal intra-articular loading (Leunig et al. 2001; Henak et al. 2014; Gala et al. 2016). Abnormal hip loads may contribute to acetabular labrum and articular cartilage damage (Cooperman 2013), which often progresses to early osteoarthritis (Jessel et al. 2009; Harris-Hayes and Royer 2011). Reliable quantification of hip loads, including joint reaction forces (JRFs) and muscle forces, may improve our understanding of tissue damage and the pathogenesis of osteoarthritis among patients with DDH.