Hip Joint Ligaments
HIP:
- Is a multi-axial ball and socket synovial joint that comprises the head of the femur and acetabulum of the os coxa.
- Receives blood from branches of the medial and lateral femoral, circumflex, superior and inferior gluteal, and obturator arteries.
- Innervated by the lumbosacral plexus
Features of the Acetabulum:
- Lunate surface - cartilage that articulates with the femur.
- Acetabular labrum - fibrocartilaginous extension of the rim of the acetabulum.
- Acetabular notch - space where the acetabular labrum and lunate surface do not completely encircle the acetabulum
- Transverse acetabular ligament - covers the acetabular notch, which creates a foramen through which blood vessels pass.
- Ligament of the head of the femur - attaches to the acetabular notch and transverse acetabular ligament; this ligament is a synovial fold that encases a blood vessel (the posterior branch of the obturator artery gives rise to this vessel).
Features of the femoral head:
- Fovea capitis - where ligament attaches to the head of the femur.
- Intertrochanteric line - indicates where the fibrous capsule attaches.
Joint capsule:
- Layers - a deeper synovial membrane and a superficial fibrous layer.
Ligaments of the joint capsule:
- Comprise thick portions of the fibrous layer
- Iliofemoral ligament – attaches to the anterior iliac spine and acetabular rim (os coxa) and to the intertrochanteric line (femur); it is very strong, and prevents hyperextension of the hip joint when standing.
- Pubofemoral ligament – attaches to the obturator crest and merges laterally with the fibrous layer of the joint capsule; prevents over-abduction of the hip joint.
- Ischiofemoral ligament -spirals from the ischial part of the acetabular rim to the base of the greater trochanter; this ligament is relatively weak.
- A hinge-type synovial joint that allows for a wide range of movement.
- Comprises the following bones: the tibia, fibula, and talus.
4 parts of deltoid (medial) ligament:
- Tibionavicular ligament
- Tibiocalcaneal ligament
- 2 Tibiotalar ligaments, anterior and posterior, which attach to the tibia and talus.
3 parts of the lateral ligament:
- Talofibular ligaments, posterior and anterior, which attach to the talus and fibula.
- Calcaneofibular ligament, which connects the fibula and calcaneus.
- Several additional joints are intrinsic to the foot, which permit movement along multiple axes.
Clinical correlations:
- Hip joint dislocates when joint capsule is torn.
- Posterior dislocation is the most common form of hip joint dislocation, and can occur in a head-on automobile collision. Rupture of the posterior acetabular labrum and ligamentum capitis femoris and injury to the sciatic nerve are likely, which results in shortening, flexion, adduction, and medial rotation of the limb.
- Anterior dislocation of the hip joint results in a slightly flexed, abducted, and laterally rotated leg.
- Medial (aka central aka intrapelvic) dislocation moves the femoral head medial to the pubic bone; fracture of the acetabulum and rupture of the bladder may accompany medial dislocation.
- An ankle sprain refers to tearing or stretching of the ligaments, which can result in swelling of the joint; because ligaments are poorly vascularized, sprains heal slowly.
- Bunion, which is inflammation and swelling on the medial side of the first metatarsophalangeal joint; a bunionectomy can be performed to remove the bunion.
- Hallux valgus is lateral deviation of the big toe, and may cause bunion.
- Hallux varus is medial deviation of the big toe, and may result from over-correction of hallux varus.