detailed anatomy of the hip joint including bones, muscles, ligaments, blood supply around the hip

1. By Dr. Ranveer Patel
Orthopaedic Surgeon, Shreeji Orthopaedic Care
*

2. *
*The hip jt is a synovial articulation between
head of femur and and acetabulum of pelvic
bone
*It is a multiaxial ball and socket joint designed
for stability and weight bearing at expense of
mobility

3. *
1) Spherical head of femur
1) The lunate surface of
acetabulum of pelvic bone
2) The acetabulum almost
entirely encompasses the
spherical head of femur
and contributes
substantially for joint
stability

4. *
*Large and cup-like
*Accepts head of the femur
*Transverse acetabular ligament
*Acetabular labrum
*Deepens concavity of acetabulum
*Lunate surface
*Covered with articular cartilage
*Acetabular fossa
*Contains ligamentum teres, fat, synovial membrane,
and blood vessels

5. *
*2/3 of a nearly perfect sphere covered by
articular cartilage
*Fovea: pit, posterior of center of head
*Ligamentum teres: runs between fovea and
the transverse acetabular ligament
*Branch of obturator artery courses through
ligament

6. *
*Projects laterally, anteriorly, and inferiorly
*Center-Edge Angle (Angle of Wiberg)
*Describes extent to which the acetabulum covers
the femoral head in the frontal plane
*35-40 degrees
*Provides protective shelf over femoral head
*Acetabular Anteversion Angle
*Extent to which the acetabulum covers femoral
head in the transverse plane
*20 degrees

7. *
*Angle between the femoral neck and the
medial side of the femoral shaft
*Adult: 125 degree

8. *
*Relative rotation existing between
the shaft and neck of the femur
*10-15 degrees “normal anteversion”
*Torsion angle and inclination angle
creates maximal congruency
between femur and acetabulum

9. *
*Synovial membrane
*Iliofemoral ligament (Y ligament)
*One of the thickest and strongest in body
*Stabilizes hip anteriorly against anterior
displacement and prevents excessive hip extension
*Pubofemoral ligament
*Strengthens hip joint inferiorly
*Taut in abduction/extension
*Ishiofemoral ligament
*Strengthens hip joint posteriorly
*Taut in IR, extension, flexion, and adduction

10. *

11. *

12. *
*Spherical femoral head remains snugly seated
within the acetabulum
*Translation is limited by the congruency of the
articulation

13. *
*3 Degrees of Freedom
*Flexion/extension: sagittal plane
*Abduction/adduction: frontal plane
*Internal/external rotation: transverse plane

14. *
*Flexors -
*Iliopsoas, Secondary - rectus femoris
*Femoral Nerve, L2,3,4
*Extensors
*Gluteus Maximus, Secondary - hamstrings
*Inferior Gluteal Nerve, S1
*Abductors
*Gluteus Medius, Secondary Minimus
*Superior Gluteal Nerve, L5
*Adductors
*Adductor Longus, Secondary - Brevis, Magnus,
Pectineus, Gracilis
*Obturator Nerve, L2,3,4

15. *
*Flexion - 110-1200
*Extension - 10-150
*Abduction - 30-500
*Adduction - 300
*Lateral rotation - 40-600
*Medial rotation - 30-400

16. *
extracapsular
arterieal ring at the
base of the femoral
neck;
- formed
posteriorly by large
branch of MFCA
- formed
anteriorly by smaller
branches of LFCA;
- superior &
inferior gluteal
artery have minor

17. *
- ascending
cervical branches
- these give
rise to retinacular
arteries;
- gives rise
to subsynovial
intra articular ring

18. *
*artery of ligamentum teres;
- derived from obturator or
MFCA;
- forms the medial epiphyseal
vessels;
- only small & variable amount
of the femoral head is nourished by
artery of ligamentum teres;

19. *
*- epiphyseal blood supply:
- arises primarily from lateral epiphyseal
vessels that enter head posterosuperiorly;
- vessels from medial epiphyseal artery
entering thru ligamentum teres;
- epiphyseal arterial branches arise as
arteries of subsynovial intraarticular ring;
- two groups of epiphyseal arteries:
lateral & inferior vessels;
metaphyseal blood supply:
- arises from extracapsular arterial ring;
- arise from branches of ascending cervical
arteries, & subsynovial intra articular ring;

20. *
*- Changes w/ Age:
- even after closure of epiphyseal
plate, there is minimal astomosis
between epiphyseal and metaphyseal
circulations;
- in the adult, greatest portion of
blood supply to head of femur is
derived from vessels on posterior
superior surface of femoral neck;

21. Femoral triangle / PRINCIPAL VASCULATURE OF THIGH

22. Trochanteric Anastomosis
anastomotic ring of arteries found
in the trochanteric fossa and
around the neck of the femur.
Formed by the union of branches
from:
1) medial circumflex femoral
artery.
2) ascending branch of the lateral
circumflex femoral artery.
3) inferior gluteal artery.
4) superior gluteal artery.
1
2
3
4
Arteries & nerves of gluteal region

23. Posterior view
Hip collateral circulation / TROCHANTERIC ANASTOMOSIS
Arterial supply to Femoral head
• Medial Femoral Circumflex
artery
• Lateral Femoral Circumflex
artery (acsending br.)
• Post. obdurator artery via artery
of femoral ligament
• Superior and inferior gluteal
arteries

24. *