Hip

Question 1

Describe the anatomy of the hip joint

Answer 1

It’s a ball and socket joint. The femoral head articulates with the acetabulum.

Question 2

List the planes of movement found in the hip

Answer 2

Flexion/Extension-Sagital plane
Abduction/adduction-frontal plane
Rotation-transverse plane

Question 3

Explain why the hip is the strongest and most mobile joint in the body

Answer 3

Because it is strong from the inside out. It starts with a deep ball and socket joint, it is then reinforced by strong ligaments, then by many muscle groups.

Question 4

Describe the “ligamentum teres” and its importance to hip proprioception.

Answer 4

This is a small ligament connecting the femoral head to the acetabulum. It provides proprioception for hip movements.

Question 5

List the three major ligaments around the hip

Answer 5

Illiofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

Question 6

Describe and explain the importance of the hip labrum

Answer 6

It’s the outer ring of cartilage on the acetabulum. It helps keep the head of the femur inside the acetabulum-thus providing stability.

Question 7

Explain the importance of gluteus medius strengthening after hip replacement

Answer 7

During the surgery, the muscle is cut so it needs to be re-strengthened, it also plays a role in gait.

Question 8

List the two major nerves passing through the hip region

Answer 8

Femoral-hip innervation
Obturator-hip
Sciatic-lower body

Question 9

Describe the changes that occur in the hip with arthritis

Answer 9

Arthritic changes, osteophyte formation, articular cartilage damage/inflammation, muscular weakness, limited joint ROM. There will be pain in the anterior part of the hip.

Question 10

Criteria for total hip replacement? (6)

Answer 10

• No open wounds
• Full weight bearing capacity
• less than 4 on pain scale
• DC’d from PT
• Med clearance from surgeon
• 12 weeks post-op (this can vary based on physical health prior)

Question 11

Criteria for greater trochanteric bursitis? (4)

Answer 11

• Full hip ROM
• Independent ambulation
• Pain less than 4
• Medical clearance

Question 12

Criteria for hip arthritis? (5)

Answer 12

• No radiating pain down leg-medial/lateral ok
• Less than 4 on pain scale
• full hip passive ROM
• full LE motor function
• medical clearance

Question 13

Describe the concept “overall leg strength”

Answer 13

That the leg is strong enough to lift bodyweight, step up, step down from curb or steps.

Question 14

List the ROM limitations after total hip replacement (3)

Answer 14

• Flexion less than 90 degrees
• No adduction across midline
• limited internal rotation

Question 15

Explain the differences in the total hip replacement and hip resurfacing.

Answer 15

With resurfacing the ligament structures remain intact, minimal bone loss (femoral head remains), greater functionality.

Question 16

Describe the indications for the “Patrick/Faber Test”

Answer 16

To assess hip capsule ROM and flexibility. Capsular tightness will usually indicate early stage arthritis.

Question 17

Describe the indications for the “Ober Test”

Answer 17

To assess IT band flexibility

Question 18

Describe the method used to identify leg length discrepancy.

Answer 18

Lying supine with knees bent, then looking or measuring femur and/or tibia discrepancies.

Question 19

Describe the “Trendelenburg Sign”

Answer 19

Have the client stand facing away from you. Have them put all their weight on one leg. If the hip drops on the opposite side, then the side that it weight bearing has a weak glute medius.

Question 20

Why does a hip fracture in elderly usually lead to total hip replacement?

Answer 20

Because the fracture can cut off the blood supply (which is already limited with age), causing vascular necrosis. This will cause the bone tissue in that area to die, and could potentially cause an infection that would spread through the body. So it is best to remove the femoral head and do a THR.