Hip

Hip Anatomy

The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments and tendons. The thighbone or femur and the pelvis join to form the hip joint.

Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight.

The hip joint is made up of the following:

  • Bones and joints
  • Ligaments of the joint capsule
  • Muscles and tendons
  • Nerves and blood vessels that supply the bones and muscles of the hip

Bones and Joints of the Hip

The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thighbone or femur, and the pelvis, which is made up of three bones called ilium, ischium and pubis.

The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium and pubis. The lower part of the ilium is attached by the pubis while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments that surround and support the hip joint.

The head of the femur rotates and glides within the acetabulum. A fibrocartilaginous lining called the labrum is attached to the acetabulum and further increases the depth of the socket.

The femur is one of the longest bones in the human body. The upper part of the thighbone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next to the femoral neck, there are two protrusions known as greater and lesser trochanters which serve as sites of muscle attachment.

Articular cartilage is the thin, tough, flexible and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction.

Ligaments of the Hip Joint

Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include:

  • Iliofemoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting over-extension of the hip.
  • Pubofemoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. It attaches the pubis to the femoral head.
  • Ischiofemoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule.
  • Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hip movement, it does have a small artery within that supplies blood to a part of the femoral head.
  • Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity increasing the stability and strength of the hip joint.

Muscles and Tendons of the Hip Joint

A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following:

  • Gluteal: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) that attach to the back of the pelvis and insert into the greater trochanter of the femur.
  • Adductors: These muscles are in the thighs which help in adduction, the action of pulling the leg back towards the midline.
  • Iliopsoas: This muscle is in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis, and extends up to the inside surface of the upper part of the femur.
  • Rectus femoris: This is the largest band of muscles located in front of the thigh. They are also called hip flexors.
  • Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backwards.

Nerves and Arteries of the Hip Joint

Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain.

The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.

In addition to these nerves, there are blood vessels that supply blood to the lower limbs. The femoral artery, one of the largest arteries in the body, arises deep in the pelvis and can be felt in front of the upper thigh.

Hip Movements

All the anatomical parts of the hip work together to enable various movements. Hip movements include flexion, extension, abduction, adduction, circumduction, and hip rotation.

Hip Bursitis

Hip Bursitis

Hip bursitis is a painful condition caused by inflammation of a bursa in the hip. Bursae are fluid- filled sacs present in joints between bone and soft tissue to reduce friction and provide cushioning during movement.

Cam Impingement

Cam Impingement

Femoroacetabular impingement (FAI) is a condition in which the bones of the hip joint grow abnormally and do not fit together properly. This leads to restricted hip movement and increased friction between the ball and socket of the hip joint resulting in damage to the joint. FAI can be associated with labral tears, cartilage damage and hip arthritis.

Hip Abductor Repair

Hip Abductor Tear

Hip abductors are a major group of muscles found in the buttocks. It includes the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.

The Gluteus medius arises at the top of the pelvic bone and runs to attach on the outer side of the thighbone or femur. The muscle controls side-to-side movement of the hip and stabilizes hip movement.

Hamstring Repair

Hamstring Tear

The three hamstring muscles, namely semitendinosus, semimembranosus and biceps femoris, run down the back of the thigh and help you bend (flex) your knee and extend your leg. Hamstring injuries are common in athletes who participate in sports which involve running such as track, soccer, and basketball.

Hip Fracture Fixation

Hip Fracture

The hip joint is a “ball and socket” joint. The “ball” is the head of the femur, or thighbone, and the “socket” is the cup shaped acetabulum. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.

Hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. The thighbone has two bony processes on the upper part - the greater and lesser trochanters.

Stress Fractures of the Hip

Stress Fractures of the Hip

Coming soon

Hip Arthroplasty

Hip Arthroplasty

Hip arthritis is joint pain and stiffness resulting in limited range of motion. Vigorous activity can increase the pain and stiffness which may cause limping while walking.

Hip Arthroscopy

Hip Arthroscopy

Hip arthroscopy is performed under regional or general anesthesia depending on you and your surgeon’s preference.

Arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into a joint to check for any damage and repair it simultaneously.

Hip Labral Repair

Hip Labral Repair

Labrum is a ring of strong fibrocartilaginous tissue lining around the socket of the hip joint. Labrum serves many functions where it acts as shock absorber, lubricates the joint, and distributes the pressure equally. It holds the head of the femur in place and prevents the lateral and vertical movement of the femur head within the joint.

Robotic-assisted Hip Replacement

Robotic-assisted Hip Replacement

Degenerative joint disease (DJD), a common cause of hip pain, is a chronic condition hampering the quality of life of affected individuals. There are different types of DJD and the most common ones include osteoarthritis (OA), post-traumatic arthritis, rheumatoid arthritis (RA), avascular necrosis (AVN), and hip dysplasia.

Hip Labral Reconstruction

Hip Labral Reconstruction

A hip labral tear is an injury to the labrum, the cartilage that surrounds the outside rim of your hip joint socket.

The hip joint is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The labrum helps to deepen the socket and provide stability to the joint. It also acts as a cushion and enables smooth movements of the joint.

Computer Navigated Hip Replacement

Computer Navigated Hip Replacement

Computer navigation technique is the latest revolution in orthopedic surgery. This technology can be used for replacement of arthritic hip joints.

Computer navigation provides the surgeon with the real time 3-D images of the mapped patient’s affected joint and the surgical instruments during surgery.

Post Less Hip Arthroscopy

Post Less Hip Arthroscopy

Coming soon

Hip Pincer Resection

Hip Pincer Resection

Coming soon