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Hip Joint

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 thigh bone 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

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 thigh bone 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 which surround and support the hip joint.

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

The femur or thigh bone is one of the longest bones in the human body. The upper part of the thigh bone 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

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 the 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

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:

  • Gluteals: 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 located in the thigh which helps in adduction, the action of pulling the leg back towards the midline.
  • Iliopsoas: This muscle is located 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 also are 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 backward.

Nerves and Arteries

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

Hip Pain

Hip Pain

Hip pain, one of the common complaints, may not always be felt precisely over the hip joint rather in and around the hip joint. The cause for pain is multifactorial and the exact position of your hip pain suggests the probable cause or underlying condition causing it.

Hip Fracture

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.

Hip Dislocation

Hip Dislocation

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.

Hip Labral Tear

Hip Labral Tear

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

Hip Instability

Hip Instability

Injury or damage to these structures can lead to a condition called hip instability when the joint becomes unstable.

Osteoarthritis of the Hip

Osteoarthritis of the Hip

Osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. It occurs most often in the elderly. This disease affects the tissue covering the ends of bones in a joint called cartilage.

Inflammatory Arthritis of the Hip

Inflammatory Arthritis of the Hip

The inflammation of the joints is referred to as arthritis. Inflammation arises when the smooth lining called cartilage at the ends of bones wears away. In some cases, the inflammation is caused when the lining of the joint becomes inflamed as part of an underlying systemic disease.

Femoroacetabular Impingement

Femoroacetabular Impingement

Femoroacetabular impingement (FAI) is a condition characterized by excessive friction in the hip joint from the presence of bony irregularities. These cause pain and decreased range of hip motion.

Hip Ligament Injuries

Hip Ligament Injuries

Injuries to the hip ligaments are commonly called a hip sprain and can range from minor tears of the ligaments to more serious injuries involving the hip muscles, tendons or bone.

Hip Flexor Strain

Hip Flexor Strain

A hip flexor strain is an overuse injury to the flexor muscles of your hip and can range from a minor stretch injury to a complete tear of the muscle fibers or tendons.

Stress Fractures of the Hip

Stress Fractures of the Hip

Stress fractures of the hip are a break in the upper part of the thigh bone (femur) that fits into the socket of the hip joint. It can occur in any part of the hip, however, it mostly occurs just below the ball of the ball-and-socket hip joint called the femoral neck.

Hip Injury

Hip Injury

A hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. It is most frequently caused after minor trauma in elderly patients, and by a high-energy trauma or serious injury in young people.

Gluteus Tendon Tear

Gluteus Tendon Tear

The gluteal muscles (situated in the buttocks) are necessary for the stability and movement of the hip joints. The tendons of two gluteal muscles (gluteus medius and gluteal minimus) are attached at the outer hip region and are often called the “rotator cuff of the hip.

Gluteus Medius Tear

Gluteus Medius Tear

A gluteus medius tear is the partial or complete rupture of the gluteus medius muscle due to severe muscle strain. Gluteus medius tears often occur at the tendinous attachment to the greater trochanter of the femur bone.

Snapping Hip Syndrome

Snapping Hip Syndrome

Snapping hip syndrome is a condition in which you hear or feel a snapping sound in the hip when you swing your legs, run, walk or get up from a chair. The sound can be experienced in the back, front or side of the hip.

Hip Bursitis

Hip Bursitis

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

Avascular Necrosis

Avascular Necrosis

Avascular necrosis, also called osteonecrosis, is a condition in which bone death occurs because of inadequate blood supply to it. Lack of blood flow may occur when there is a fracture in the bone or a joint dislocation that may damage nearby blood vessels.

Iliopsoas Tendonitis

Iliopsoas Tendonitis

Iliopsoas tendonitis also referred to as snapping hip syndrome, is an inflammation of the iliopsoas tendon or the surrounding area. The iliopsoas is the hip flexor tendon located over the front of the hip socket.

Hip Tendonitis

Hip Tendonitis

Tendons are strong connective tissue structures that connect muscle to bone. Hip tendonitis is a condition associated with degeneration of the hip tendons. This condition is mainly caused due to strain on the tendons which may occur due to overuse or biomechanical problems.

Periprosthetic Hip Infection

Periprosthetic Hip Infection

A very small percentage of patients (less than 1%) who undergo hip replacement may develop an infection around the hip joint following surgery. This infection is called a periprosthetic hip infection.

Developmental Dysplasia

Developmental Dysplasia

Developmental dysplasia of the hip (DDH) or hip dysplasia is a condition that is seen in infants and young children because of developmental problems in the hip joint.

Ischiofemoral Impingement

Ischiofemoral Impingement

Ischiofemoral impingement is a condition in which there is an abnormal contact (impingement) between the soft tissues of the thigh bone and hip due to the narrowing of space between the lesser trochanter and ischium, resulting in significant hip pain.

Total Hip Replacement

Total Hip Replacement

Total hip replacement is a surgical procedure in which the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. The main indication for total hip replacement is arthritis.

Revision Hip Replacement

Revision Hip Replacement

During total hip replacement, the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. At times, hip replacement implants can wear out for various reasons and may need to be replaced with the help of a surgical procedure known as revision hip replacement surgery.

Hip Arthroscopy

Hip Arthroscopy

Hip arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into your hip 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 a shock absorber, lubricates the joint, and distributes the pressure equally.

Hip Preservation Surgery

Hip Preservation Surgery

The hip is a ball and socket joint comprising of the femur (thigh bone) and the pelvic bone. The head of the femur (ball) articulates with a cavity (socket) called the acetabulum in the pelvic bone.

Proximal Hamstring Repair

Proximal Hamstring Repair

The hamstrings are a group of three thigh muscles that extend from the pelvis to the knee joint. These muscles help in extending your leg and bending your knee. Therefore, any damage to the hamstring muscle group affects both hip and knee movements.

Hip Cartilage Restoration

Hip Cartilage Restoration

Hip cartilage restoration is a surgical technique to repair damaged articular cartilage in the hip joint by stimulating new growth of cartilage or by transplanting cartilage into areas with defects in order to relieve pain and restore normal function to the hip.

Open Gluteus Medius Repair

Open Gluteus Medius Repair

A gluteus medius tear or rupture is a condition characterized by a severe strain of the gluteus medius muscle that results in a partial or complete rupture of the muscle.

Ultrasound Guided Hip Injections

Ultrasound Guided Hip Injections

An ultrasound scan is an imaging procedure that uses high-frequency sound waves to produce pictures of the inside of the body. Ultrasound-guided hip joint injections are used to diagnose the underlying cause and relieve hip pain.

Physical Examination of the Hip

Physical Examination of the Hip

The physical examination of the hip by your doctor includes a visual inspection of your hip, palpation of the hip to diagnose tenderness or any abnormality, etc; and testing range of motion of the hip.

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