Hip Joint overview

Question 1

Hip joint bones and type

Answer 1

osteology: ilium, ischium, pubis, femur
type: ball and socket

Question 2

Acetabulum lunate surface and fossa

Answer 2

Lunate surface
-covered with hyaline cartilage which articulates with the head of the femur
Fossa
-deepest portion of the acetabulum

Question 3

The Fovea on the head of the Femur coverage and attachment

Answer 3

• not covered with articular cartilage

- attachment of ligamentum teres

Question 4

Angle of Inclination plane and axis of hip

Answer 4

• Occurs in the frontal plane

- Between axis through femoral head/neck

Question 5

What is the normal angle of inclination

Answer 5

125 degrees

Question 6

Coxa valga

Answer 6

pathological increase

> 125

Question 7

Coxa vara

Answer 7

pathological decrease

< 125

Question 8

Angle of inclination serves to optimize…

Answer 8

joint surface alignment

Question 9

What is a slipped capital femoral epiphysis (SCFE)

Answer 9

A decrease in femoral neck-shaft angle (coxa vara) along with a high body mass index

Question 10

SCFE is most common in what age group?

Answer 10

adolescents

Question 11

Angle of Torsion plane and axis of femur

Answer 11

• transverse plane

- between axis through femoral head/neck and the distal femoral condyles

Question 12

Which degree of anteversion of the femur allows for optimal alignment and joint congruence

Answer 12

15 degrees

-norm= 8-20 degrees

Question 13

Excessive Anteversion (inc. angle of torsion) of femur reduces what?

Answer 13

hip joint stability

Question 14

femoral anteversion commonly found with coxa _____

Answer 14

valga

Question 15

Excessive anteversion is associated with _____ hip IR and _____ ER

Answer 15

increased

decreased

Question 16

Retroversion (dec. angle of torsion) of the femur can cause what?

Answer 16

impingement

Question 17

Retroversion is associated with _____ hip IR and _____ ER

Answer 17

decreased

increased

Question 18

What does Excessive Anteversion make gait look like? Why do people do it?

Answer 18

“in-toeing”

-improves joint congruency

Question 19

Why can compensation patterns with excessive anteversion cause future issues?

Answer 19

-Overtime it may cause shortening of muscles and ligaments crossing hip and reducing ER of the hip

Question 20

How is the opening of Acetabulum positioned?

Answer 20

laterally with inferior and anterior tilt

Question 21

Femoral head coverage is determined by acetabular _____

Answer 21

depth

Question 22

What is the center edge angle? Normal range?

Answer 22

measurement of acetabular depth

-25-35 degrees

Question 23

What is the degree for coxa profunda/acetabular overcoverage?

Answer 23

> 45 degrees

Question 24

What is Anteversion of Acetabulum and normal range?

Answer 24

extent to which acetabulum faces anteriorly

-normal = 20 degrees

Question 25

Acetabular Abnormalities: Abetabular dysplasia

Answer 25

shallow acetabulum

Question 26

Acetabular Abnormalities: Coxa profunda/Acetabular overcoverage

Answer 26

Acetabulum excessively covers the femoral head

Question 27

Excessive anteversion of the Acetabulum can lead to..

Answer 27

instability and dislocation

Question 28

Excessive retroversion of the Acetabulum can lead to..

Answer 28

over coverage/impingement

Question 29

Femoral Acetabular Impingement (FAI): Cam deformity

Answer 29

- Extra bone at anterior-superior region of femoral head and neck junction - Loss of natural tapering of femoral head - Impingement occurs of bulge of femoral head against the acetabulum

Question 30

Femoral Acetabular Impingement (FAI): Pincer deformity

Answer 30

- Abnormal bony extension of anterior-lateral rim of acetabulum - Often associated with deep acetabulum or overly retroverted acetabulum

Question 31

Articular Congruence: | Maximal congruency in non-weight-bearing position:

Answer 31

Flexion, abduction, slight external rotation

Question 32

Articular Congruence: This position is utilized in the diagnosis of _______ to improve joint congruency

Answer 32

hip dysplasia

Question 33

How is the hip bone articular congruency different from most joints?

Answer 33

Most joints have theirs in a closed packed position but the hip does not

Question 34

Structural Adaptations to Weight Bearing: | Bending moment

Answer 34

Half the weight of HAT passes down through pelvis & GRF travels up the shaft

Question 35

Superior and Inferior forces in Bending moment

Answer 35

Superiorly: tensile force Inferiorly: compressive force

Question 36

Trabecular systems

Answer 36

- Provide structural resistance - Strongest where they cross at right angles - Zone of weakness is where they are thin and do not cross

Question 37

Hip joint capsule is a substantial contributor to hip joint ______

Answer 37

stability

Question 38

Fibers of Hip joint capsule

Answer 38

Irregular, dense fibrous structure (longitudinal and oblique fibers)

Question 39

Capsule of Hip joint is thickened _______

Answer 39

anterosuperiorly | -where predominate stresses occur

Question 40

Capsule of Hip joint is thin and loose ______

Answer 40

posteroinferiorly | -most likely to dislocate posteriorly

Question 41

Iliofemoral ligament limits what and provides stability where?

Answer 41

- IR and ER | - provides anterior stability to joint

Question 42

Pubofemoral ligament limits

Answer 42

ER in extension

Question 43

Ischiofemoral ligament limits

Answer 43

IR

Question 44

All ligaments of the hip joint tighten when? Passive tension when?

Answer 44

- All tighten with hyperextension | - Passive tension in capsule and ligaments at rest in standing

Question 45

Transverse acetabular ligament

Answer 45

- part of labrum - no cartilage cells - protects the blood vessels that travel beneath it to get to the head of the femur

Question 46

Acetabular labrum shape and function

Answer 46

- wedge shaped | - deepens concavity

Question 47

Ligamentum teres function? What movement can injure it?

Answer 47

- traditionally believed to serve only as a conduit for blood supply to femoral head - excessive ER can strain/potentially tear

Question 48

The neck of the femur is angulated so that the head faces ....

Answer 48

medially, superiorly and anteriorly with respect to the femoral shaft and distal femoral condyles

Question 49

Ambulating with toe-in _________ moment arm of hip abductors muscle leverage

Answer 49

increases

Question 50

With both Cam and Pincer deformities, what movement can cause impingement?

Answer 50

Hip Flexion and IR

Question 51

The Acetabular Labrum acts as a seal to maintain ...

Answer 51

negative intraarticular pressure