Amir H. BakhtiaryPhD, PT

Associate Professor

Physiotherapy DepartmentRehabilitation faculty

Semnan University of Medical Sciences

Hip Joint Kinesiology

Can you explain the type of Hip Joint, its movement and main role?

• A ball and socket joint with 3 degree of freedom• Flexion and Extension (Sagital)• Abduction and Adduction (Frontal)• Medial and Lateral Rotation (transverse)

• Main role of Hip Joint• Weight bearing

• Static (Standing position)• Dynamic (Ambulating, Running, Stepping)

Can you describe the acetabulum orientation?• Laterally, • Inferiorly, (Center Edge Angle)

• 38 degree in Men, 35 degree in women• Increase with age• Decreased angle cause superior instability

• Anteriorly, (Anteversion Angle)• 18.5 degree for men, 21.5 degree for women• Increased angle cause Anterior instability

Center Edge AngleOr

Wiberg angle

• is rimmed by a ring of wedge-shaped fibrocartilage

• is attached to the periphery of the acetabulum

• is not load-bearing • Serves a role in proprioception and

pain sensitivity• help to protect the rim of the

acetabulum

Acetabular labrum

How does acetabular labrum may increase stability of hip Joint?

1. Increase the depth of acetabulum2. Increase the concave of acetabulum3. Increase the contact area of acetabulum4. Cover the head of femour

Can you explain distal articular surface head of femur?• Rounded covered by Hyaline cartilage• Less radius of curvature in women• Oriented

• Medially,• Superiorly, (inclination Angle) in Frontal

• 125 in adult and 120 in elderly• Less in women because of wide pelvic• Pathologic condition: Coxa Valga and Coxa Vara

• Anteriorly, (Torsion Angle) in transverse

Inclination Angle

The axis of the femoral head and neck forms an angle with the axis of the femoral shaft called

the angle of inclination.

Coxa Valga and Coxa Vara

Coxa vara and Coxa valga

What is Torsion Angle and its pathological condition?

• 40 degree in the born child• Decrease 1.5 degree each year• 10-15 degree in adult• Pathological Conditions

• Increased torsion angle (Anteversion Angle)• Decreased torsion angle (Retroversion angle)

Torsion Torsion Angle Angle

Abnormal Torsion Angle

Anteversion Angle

Retroversion Angle

Abnormal Torsion and Inclination Angle

Compensation Changes in Hip Joint

Stability Changes Biomechanical Changes in WB

Biomechanical Changes in

muscles

Hip Joint malfunction

Knee and Ankle Joint malfunction

سير تكاملي بدن انسان

Explain the articular congruence of the hip

joint

Frog leg Position(Flexion, Abduction, Lat Rotation)

Maximum Contact Area

• Explain the Hip Joint Capsule• Strong and full of fiber• Cover head and neck of femur• Have two kind of fibers

• Longitudinal (surface)• Spiral (deep)

• More Thickness in ant and superior• Tin in post and Inferior part• Provide stability for joint

Explain the Hip Joint ligaments• Ligament Teres

• Inside the capsule but out side the synovial• Triangle shape• Stretch in semi-flex and ADD• Nutrition of the femoral head

• Iliofemoral Lig• Pubofemoral Lig• Ischiofemoral Lig

• In standing position (few Ext) cause tension in these ligaments.

In normal condition Capsule and Ligaments can tolerate 70% of body Weight

Ligament Teres

Iliofemoral and Pubofemoral Ligaments

Ischiofemoral Ligament

Which movement was limited by the hip ligaments?

• Iliofemoral Lig• Lat rot, Add (upper band) Abd,

(lower Band) and Ext• Pubofemoral Lig

• Lat rot, Abd and Ext• Ischiofemoral Lig

• Med rot, Add, Abd and Ext

Some important positions in Hip Joint• Closed pack

• Ext, few Abd and Med Rot

• Most contact area• Flex, Abd, Lat Rot

Between these positions the joint may be dislocated such as:

Flex and Add (dashboard Injury)

• Decreased in Tension of Capsule and ligaments in flex and few Abd• This is the optional position for patients complain of

• Edema due to increase of sinovium fluid• Inflammation in capsule or lig.