The Hip

Question 1

Bones don’t ossify until what age?

Answer 1

25 years old

Question 2

Risser’s sign

Answer 2

Indirect measure of skeletal maturity - x-ray of illium

Question 3

The acetabular labrum is poorly ________ but significantly _______________

Answer 3

Vascularized - poor healing

Significantly innervated - proprioception, pain

Question 4

Articular cartilage is thickest where for both acetabulum and femoral head?

Answer 4

Superiorly - the most force travels through this area (OVERHANG)

Question 5

Center edge angle of Wiberg - what is it? Angles?

Answer 5

Measure of acetabular depth - helpful in determining dysplasia/joint stability

Straight down through the center of the head of the femur and the edge of the acetabulum

16* or less = definite dysplasia - joint instability
16-25= possible dysplasia
25-35 = optimal
40* or higher = too high - impingement

Question 6

CAM/pistol grip deformity

Answer 6

“Door too big for frame”

Neck of the femur starts bulging due to extra bone, causes inflammation, impingement of labrum

Damage to cartilage first, more pain anteriorly

Question 7

Pincer impingement

Answer 7

Acetabulum coverage too much

Pain anterior and posterior, anterosuperior region - does damage to labrum first, ossification of labrum

Question 8

Angle of inclination (frontal plane) — what is it? Angles?

Answer 8

Angle between femoral head and neck AND shaft of femur
125* = normal
105* = Coxa vara
140* = Coxa valga

Question 9

Angle of torsion (transverse plane)

Answer 9

Anteversion/retroversion - angle between femoral neck and head to femoral condyles

Normal anteversion = 15*
Excessive Anteversion = >15-20/ 35 - compensation is internal rotation of hip
Retroversion = <15-20/ 5 - compensation is external rotation of hip

Question 10

Capsular pattern for hip

Answer 10

Greatest loss of internal/medial rotation, hip flexion
Some loss of abduction
Slight loss of extension

Question 11

Hip joint ligaments: names

Answer 11

Illliofemoral // y ligament

Pubofemoral

Ichialfemoral

Question 12

Hip ligaments: which resist hip extension?

Answer 12

Illiofemoral, pubofemoral, ischiofemoral

Question 13

Hip ligaments: resist abduction

Answer 13

Pubofemoral

Question 14

Hip ligaments: hip internal rotation resistance

Answer 14

Ischiofemoral

Question 15

Hip ligaments: external rotation resistance

Answer 15

Illiofemoral and pubofemoral

Question 16

Hip joint blood supply

Answer 16

Medial and lateral femoral circumflex arteries - **medial supplies the most
Obturator artery via ligamentum teres
Inferior and superior gluteal arteries supply joint capsule