Hip Joint Featured Image

Hip Joint – Bones, ligaments, blood supply and innervation |Anatomy|

We are going to be looking at the hip joint, its articulations, movements, blood supply, and innervation.

So, the hip joint is a ball and socket synovial joint, forming the connection between the lower limb and the pelvic girdle.

And the hip joint is also multi-axial meaning that it rotates on more than one axis. Which allows for a wider range of movement. Of course, the hip joint is designed for stability and weight-bearing.

Hip joint

The head of the femur articulates with the lunate surface of the acetabulum of the pelvis.

Head of femur

The lunate surface is concave, which is like the shape of a crescent moon as the name lunate suggests. And the hip joint can also be referred to as the acetabulofemoral joint.

lunate surface

 

Both the lunate surface of the acetabulum and the head of the femur are covered by hyaline cartilage. And hyaline cartilage is simple cartilage found on many articulating surfaces.

So, the acetabulum is the part of the pelvis where the ilium, ischium, and pubis bones merge and its concave almost entirely encompasses the head of the femur. Which contributes to the stability of the joint.

Hip-Bones-Pelvic-Girdle

At the center of the acetabulum is a non-articulating surface which is known as the acetabular fossa. This part of the acetabulum contains loose connective tissue.

acetabular fossa

 

The acetabular labrum is the fibrocartilaginous collar or lip that surrounds the bony rim of the acetabulum and it bridges across the acetabular notch.

acetabular notch

 

The labrum of the acetabulum increases the stability of the hip joint by deepening the acetabulum and increasing the area of articulation with the head of the femur.

labrum of the acetabulum

 

The ball of the ball and socket hip joint is the rounded head of the femur. Which sits within the concavity of the acetabulum, which is our socket of the joint.

The head of the femur is entirely covered by hyaline cartilage except for an area called fovea capitis femoris.

fovea capitis femoris

 

This is where the ligament of the head of the femur connects the femur at the fovea to the acetabular fossa, the transverse acetabular ligament, and the margins of the acetabular notch.

margins of the acetabular notch

 

 Capsule OF the Hip Joint:

So, the joint capsule of the hip joint attaches to the acetabular labrum and the transverse acetabular ligament proximally but is underneath the fibrous capsule.

underneath the fibrous capsule

The joint capsule is a strong fibrous capsule that can accommodate a wide range of movements and the capsule is strengthened and reinforced by the help of three ligaments.

Anteriorly and superiorly by the iliofemoral ligament, which connects the anterior and inferior iliac spine and the acetabular rim to the femoral intertrochanteric line. The iliofemoral ligament is the strongest of the hip joint ligaments.

iliofemoral ligament

 

Inferiorly and anteriorly, the pubofemoral ligaments arise from the obturator crest and the superior ramus of the pubis and blend with the capsule and the medial part of the iliofemoral ligament.

ischiofemoral ligament

 

Posteriorly, the ischiofemoral ligament seen here from a posterior view connects the ischial part of the acetabular rim of the neck of the femur.

The fibers from the three ligaments are arranged in a spiral fashion around the hip joint which helps stabilize the joint by pulling the head of the femur medially into the acetabulum.

This reduces the amount of muscle energy required to maintain a standing position and prevents the hyperextension of the hip as well as excessive abduction.

 

Movements of the Hip Joint:

So the range of hip movement in the hip joint include

  • Flexion – Movement of the leg forward
  • Extension – Movement of the leg backward
  • Abduction – Movement of the leg laterally
  • Adduction – Movement of the leg medially towards the midline of the body
  • Medial rotation – Internal rotation of the thigh towards the midline.
  • Lateral rotation – Outward rotation of the thigh from the midline of the body.
  • Circumduction – Conical precise 360degree movement of the leg.

Hip Movement

 

Blood Supply of the Hip Joint:

Blood is supplied to the hip joint primarily by the medial and lateral circumflex femoral arteries – the medial shown on the left and the lateral shown on the right. Both of these arise from the deep femoral artery.

deep femoral artery

And also by the artery to the head of the femur which runs within the ligament of the head of the femur which is shown in green and the artery to the head of the femur is a branch of the obturator artery.

obturator artery

 

Innervation of the Hip Joint:

(Green color indicates nerve)

1. Innervation of the hip joint comes anteriorly from the femoral nerve. 

anteriorly from the femoral nerve

2. Inferiorly from an articular branch of the anterior division of the obturator nerve.

anterior division of the obturator nerve

3. Poster superiorly from the superior gluteal nerve.superior gluteal nerve
4. Laterally from the articular branch of the sciatic nerve.

sciatic nerve.

 

 

For further advice do reach out to your local doctor or family doctor.

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Diagnosis of hip fracture

 

Hip fracture is known to be the most common fracture. It is especially prevalent in older people. After age 65, human bones become weak and it almost requires surgery. This injury can often be life-threatening. Thus it needs to be treated quickly. Before taking any decision let’s get to know about how to diagnose the hip fracture.

During a physical exam, the doctor will ask for your complete medical history. Also, the physician will look for any injuries commonly associated with hip fractures. To determine whether an open fracture has occurred, the doctor will examine any lacerations and determine how stable the hip is will press on the front and back of the pelvic area. To look for haemorrhage that may signify bone penetration into the rectum, a rectal examination also may be performed.

Tests for a broken hip:-

X-ray

X-radiation or commonly known as X-ray uses invisible high energy electromagnetic radiation to produce images of internal tissues, bones and organs onto film. It is usually sufficient for the majority of fractures.

MRI (Magnetic Resonance Imaging)

It is a medical imaging technique that uses a combination of large magnets, radio frequencies and a computer. It is used to produce detailed images of organs and structures within the body; especially useful for assessing soft tissue around injured joints and bones.

Computed tomography scan (CT scan)

It uses a combination of x-rays and computer technology to produce 3D cross-sectional images, both horizontally and vertically, of the affected area, including bones, fat, soft tissue.

Bone scan

It uses a radioactive dye to visualize the bones. It’s different from plain x-rays or CT in that because of a nuclear medicine imaging technique, it shows bone metabolism and cell activity in the bones. Bone scans are used to assess including cancer of the bone or metastasis, location of bone inflammation and fractures, and bone infection.

This is how one can diagnose a hip fracture. We recommend you to visit a doctor instead of doing it by yourself. We hope this information adds value to your knowledge. Watch out this space for more such information. Greetings for SYS Medtech International PVT. LTD.

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