Biomechanics Of Hip Joint

Also called as coxofemoral joint

Articulation of head of femur with acetabulum
of pelvis
Diarthrodial ball & socket joint with 3°
freedom movement
Flexion/Extension – saggital plane
Abduction/adduction – frontal plane
Medial/Lateral rotation – transverse plane
• Primarily structured to serve weight bearing
function
• Function of this joint is to support weight of
the head,arms & trunk (HAT) both in static
erect posture and in dynamic postures such
as ambulation,running and stair climbing
Structure of Hip Joint:
Proximal Articular surface:
Acetabulum- pubis 1/5th,
ischium2/5th, ilium the remaining
Horse shoe shaped portion of the periphery is
covered with hyaline cartilage and articulates with
the head of femur
Inferior aspect is called as acetabular notch
Central deepest portion called acetabular fossa is
nonarticular and contains fibroelastic fat covered
with synovial membrane and femoral head doesn't
articulate this area
 Center edge of angle/angle of Wiberg:
Acetabulum is oriented on the pelvis to face
laterally,inferiorly and anteriorly
Used to assess the magnitude of inferior orientation
of acetabulum and is assessed using CT scan
Angle between line connecting the lateral rim of
acetabulum & center of femoral head
38° - males
35° - females
Smaller angle may result
in diminished coverage of
head of femur
Increased risk of superior dislocation of head of
femur
Center-edge angle or angle of Wiberg(1) - Normally 30° to 40°, this
angle represents the degree of femoral head coverage in the frontal
plane. An angle of less than 30° is a characteristic sign of hip
dysplasia
 Acetabular Anteversion:
Magnitude of anterior orientation of
acetabulum is referred as angle of acetabular
anteversion
18 .5° - males
21.5° - females
Pathological increases are associated with
decreased joint stability and increased
tendency for anterior dislocation of head of
femur
 Acetabular labrum:
Given the need for stability, hip joint has an
accessory structure in the form of labrum
which is fibro cartilage
Entire periphery of the acetabulum is
rimmed by ring of wedge-shaped labrum
which is fibrocartilage
Labrum not only deepens the socket but
increases the concavity
Transverse acetabular ligament is a part of
the labrum and spans the articular gap at the
base of the articular horseshoe
Distal articulating surface:
Head of Femur:
• Rounded hyaline cartilage covered surface
• Inferior to the most medial point a pit called
fovea capitis is present which is not covered
with cartilage and is the point at which the
ligament of head of femur is attached
• Head is attached to the neck
which is angulated so the
head faces medially, superiorly
and anteriorly
Angulation of Femur:
There are 2 angulations made by head & neck
of femur relative to the shaft
 Angle of inclination (neck shaft angle):
Occurs in frontal plane
Angle between an axis through femoral
head and neck and the longitudinal axis of
femoral shaft
Early infancy-150°
Adult-125°
Elderly –120°
• Pathologic increase in medial angulation is
called as COXA VALGA and results in
increase in leg length
• Pathologic decrease is called as COXA
VARA and there is decrease in leg length

Angle of inclination COXA VALGA COXA VARA

Angle of inclination (2)- This angle, between the femoral neck and
the shaft of the femur, is normally 125°. In hips with dysplasia, it is
commonly increased but also may be decreased
Coxa Valga
X-ray - normal left side and coxa vara on right side
 Angle of Torsion:
Occurs in transverse plane
When femur is viewed from above with the
axis of the femoral condyles neck of the
femur is seen to have an anterior angle
Axis through the femoral head and neck
will make an angle with an longitudinal axis
through the distal femoral condyles that
reflects anterior twisting
of head and neck in
relation to condyles
Best viewed by looking down the length of
the femur from top to bottom
Axis through the head and neck will lie at
an angle to the axis through the condyles
This angulation reflects the twist in the
bone
Normal range is 10°-15°
Normal angle of torsion is referred as
anteversion as angle is made anteriorly
Pathologic increase – anteversion(more than
normal 10° –15°) and is one factor considered
to cause in-toeing or pigeon toe

Angle of torsion

Anteversion
Pathologic decrease – retroversion which may
lead to out toeing

Angle of torsion

Retroversion
 Angle of torsion

Anteversion Retroversion

in-toeing out toeing

Articular congruence:
• Hip is a congruent joint
• In neutral standing articular surface of the
femoral head remains exposed anteriorly
and superiorly
• Acetabulum does not fully cover the head
superiorly
• In neutral hip joint articular cartilage of the
head of femur is exposed anteriorly and to a
lesser extent superiorly
Maximum articular contact of head of
femur with acetabulum is obtained when
femur is flexed,abducted and laterally
rotated(frog-leg position)
This position is used for immobilization
when the goal is to improve articular
contact and joint congruence in cases of
CDH & Legg-Calve-Perthes disease