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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 Arthritis

Hip Arthritis

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.

Hip Fracture

Hip Fracture

A hip fracture is a break that occurs near the hip in the upper part of the femur or thighbone. The thighbone has two bony processes on the upper part - the greater and lesser trochanters. The lesser trochanter projects from the base of the femoral neck on the back of the thighbone.

Hip Dislocation

Hip Dislocation

Hip dislocation occurs when the head of the femur moves out of the socket. The femoral head can dislocate either backward (posterior dislocation) or forward (anterior dislocation).

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.

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.

Total Hip Replacement

Total Hip Replacement

Total hip replacement is a surgical procedure in which the damaged cartilage and bone is removed from the hip joint and replaced with artificial components.

Bikini Incision anterior hip replacement

Bikini Incision Technique

Anterior hip replacement surgery is performed under general anesthesia or regional anesthesia. You will lie down on your back, on a special operating table that enables your surgeon to perform the surgery from the front of the hip.

Direct Anterior Hip Replacement

Direct Anterior Hip Replacement

We understand that making sure you know what to expect from the hip replacement experience is important to you. If you have additional questions as you are reading through this material, please reach out to us to discuss.

Revision Hip Replacement

Revision Hip Replacement

Revision hip replacement is a complex surgical procedure in which all or part of a previously implanted hip joint is replaced with a new artificial hip joint. Total hip replacement surgery is an option to relieve severe arthritis pain that limits your daily activities.

Hip Preservation

Hip Preservation

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. To facilitate the smooth and frictionless movement of the hip joint, the articulating surfaces of the femur head and acetabulum are covered by spongy articular cartilage.

Robotic Assisted Hip Surgery

Robotic Assisted Hip Surgery

Robotic assisted hip surgery is a minimally invasive surgical procedure that involves the use of a specialized robotic system to remove the damaged parts of a hip joint and replace them with an artificial prosthesis or implant.

Robotic Total Hip Replacement

Robotic Total Hip Replacement

Total hip replacement is a surgical technique where the severely damaged cartilage and bone of the hip joint are removed and substituted with an artificial prosthesis which is bio-compatible and functions like a normal hip.

Minimally Invasive Total Hip Replacement

Minimally Invasive Total Hip Replacement

A minimally invasive approach has been developed in recent years where surgery is performed through one or two smaller incisions rather than the single long incision as in the traditional approach.

ConforMIS® Hip

ConforMIS® Hip

The Conformis Hip System, introduced in July 2018, is the only primary total hip replacement system on the market designed with 3D imaging technology to provide a stem and acetabular cup size that matches each patient’s specific anatomy. The implant system includes a single-piece stem with patient-specific neck, acetabular cup, iPoly XE® (highly crosslinked vitamin-e infused UHMWPE) polyethylene liner, and a choice of ceramic or cobalt chrome femoral head.