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1. Hip joint

2. Introduction Type- synovial Subtype- Ball and socket variety and freely movable joint Bone- Acetabulum of hip bone medially and head of femur laterally. Articular surfaces- The acetabulum presents a horseshoe shaped lunate articular surface, an acetabular notch and an acetabular fassa . The head of femur forms more than half of a sphere which is covered with hyaline cartilage except at fovea capitis .

3. Introduction The hip joint is unique in having high degree of stability as well as mobility. The stability and strength of hip joint depends on Depth of acetabulum Tension and strength of ligaments Strength of surrounding muscles Length and obliquity of neck of femur. Atmospheric pressure.

4. Ligaments Fibrous capsule Iliofemoral ligament Pubofemoral ligament Ischiofemoral ligament Ligament of head of femur Acetabular labrum Transverse ligament of acetabulum

5. 1.The fibrous capsule It is attached on The Hip bone- to the acetabular labrum including transverse acetabular liament . To the bone above and behind the acetabulum The femur- To the intertrochanteric line in front 1cm medial to intertrochanteric crest behind Structure of capsule- it is made of 2 types of fibres The outer fibres - longitudinal The inner fibres - circular ( Zona orbicularis).

6. 2.Iliofemoral ligament It lies anteriorly and called as ligament of Bigelow It is one of the strongest ligament in the body Prevents the trunk from falling backward in standing posture. It is inverted Y shaped (triangular shape). Its apex is attached to the lower half of anterior inferior iliac spine. Base is to intertrochanteric line Upper oblique and lower vertical fibers forms thick and strong bands. The middle fibers are thin and weak.

7. 3.Pubofemoral joint It supports the joint inferomedially Triangular in shape Superiorly attached to iliopubic eminence, obturator crest and obturator membrane. Inferiorly it merges with anteroinferior part of capsule and with lower band of iliofemoral ligament.

8. 4.Ischiofemoral ligament It is comparitively weak ligament Covers the joint posteriorly. Its fibers are twisted, and span from the ischium at a point below and behind the acetabulum and attach at the intertochanteric line anteriorly.

9. 5.Ligament of head of femur It is also called as round ligament or ligamentum teres of head of femur. It is flat and triangular in shape. Apex is attached to fovea capitis and base ia attached to transverse ligament and the acetabular notch.

10. Ligaments 6. Acetabular labrum- It is fibrocartilagenous rim attached to the margin of acetabulum. It narrows the mouth and increases depth of the acetabulum and helps in holding the head of femur in position. 7. Transverse ligament of acetabulum- It bridges the acetabular notch. The notch is converted into a foramen and transmits the acetabular vessels and nerves to the joint.

11. Relations Anterior – tendon of iliopsoas seperated from the joint by a bursa and femoral vein, femoral artery and femoral nerve Posterior- tendon of obturator externus covered by quadratus femoris , obturator internus and gemelli , piriformis , sciatic nerve and gluteus maximus . Superior- reflected head of rectus femoris covered by gluteus minimus , gluteus medius and partially by gluteus maximus Inferior- lateral fibers of pectinius and obturator externus .

12. Blood and Nerve supply Arterial supply- Obturator art, two circumflex femoral arteries. The medial and lateral circumflex femoral arteries form an arterial circle around the capsular attachment on the neck of femur. A part of head near fovea capitis is supplied by acetabular branches of the obturator and medial circumflex femoral arteries. Nerve supply- Femoral nerve, anterior division of obturator nerve Nerve to quadratus femoris , superior gluteal nerve.

13. Movements Flexion- psoas major and iliacus Extension- gluteus maximus and hamstrings Adduction- adductor longus , brevis and magnus . Abduction- gluteus medius and minimus Medial rotation- tensor fasciae latae and anterior fibers of gluteius and minimus . Lateral rotation- two obturators , two gemelli and quadratus femoris .

14. Clinical anatomy Congenital dislocation- the head of the femur slips upwards onto gluteal surface of the ilium because the upper margin of acetabulum is developmentally deficient. Perthe’s disease/avascular necrosis- characterized by destruction and flattening of head of the femur with an increased joint space in X-ray. Tuberculosis of the hip- may cause referred pain in the knee.