DR ANOOP S

THE HIP JOINT IS A MULTIAXIAL SYNOVIAL JOINT OF BALL-AND-SOCKET TYPE.

ACETABULUM

APPROXIMATELY HEMISPHERICAL CAVITY CENTRAL ON THE LATERAL ASPECT OF THE INNOMINATE BONE.

FACING ANTEROINFERIORLY. SURROUNDED BY AN IRREGULAR

MARGIN DEFICIENT INFERIORLY AT THE ACETABULAR NOTCH.

STARTS TO OSSIFY AT 12 YEARS FUSE AT 17 YEARS

THE ACETABULAR FOSSA FORMS THE CENTRAL FLOOR-ROUGH AND NON ARTICULAR.

THE ARTICULAR LUNATE SURFACE IS WIDEST ABOVE (THE 'DOME'), WHERE WEIGHT IS TRANSMITTED TO THE FEMUR.

THE HIP JOINT IS A MULTIAXIAL SYNOVIAL JOINT OF BALL-AND-SOCKET TYPE

ARTICULAR SURFACES THE FEMORAL HEAD ARTICULATES WITH

THE CUP-SHAPED ACETABULUM, ITS CENTRE LYING A LITTLE BELOW THE MIDDLE THIRD OF THE INGUINAL LIGAMENT.

THE ARTICULAR SURFACES ARE RECIPROCALLY CURVED.

THE CLOSE-PACKED POSITION IS IN FULL EXTENSION, WITH SLIGHT ABDUCTION AND MEDIAL ROTATION.

LEAST PACK SEMIFLEXION

THE FEMORAL HEAD IS COVERED BY ARTICULAR CARTILAGE, EXCEPT FOR A ROUGH PIT FOR THE LIGAMENTUM TERES

IN FRONT, THE CARTILAGE EXTENDS LATERALLY OVER A SMALL AREA ON THE ADJOINING NECK

CARTILAGE THICKNESS IS MAXIMAL ANTEROSUPERIORLY IN THE ACETABULUM AND ANTEROLATERALLY ON THE FEMORAL HEAD

THE ACETABULAR ARTICULAR SURFACE IS AN INCOMPLETE RING, THE LUNATE SURFACE

DEFICIENT INFERIORLY OPPOSITE THE ACETABULAR NOTCH

THE ACETABULAR FOSSA IS DEVOID OF CARTILAGE BUT CONTAINS FIBROELASTIC FAT LARGELY COVERED BY SYNOVIAL MEMBRANE

ACETABULAR DEPTH IS INCREASED BY THE ACETABULAR LABRUM

DEEPENS THE CUP AND BRIDGES THE ACETABULAR NOTCH AS THE TRANSVERSE ACETABULAR LIGAMENT.

DIAMETER OF THE ACETABULAR CAVITY IS CONSTRICTED BY THE LABRAL RIM

EMBRACES THE FEMORAL HEAD, MAINTAINING JOINT STABILITY

FIBROUS CAPSULE STRONG AND DENSE

ATTACHMENT

ANTERIORLY TO THE INTERTROCHANTERIC LINE

SUPERIORLY TO THE BASE OF THE FEMORAL NECK,

POSTERIORLY 1 CM ABOVE THE INTERTROCHANTERIC CREST

INFERIORLY TO THE FEMORAL NECK NEAR THE LESSER TROCHANTER

IT HAS TWO SETS OF FIBRES, CIRCULAR AND LONGITUDINAL

THE CIRCULAR FIBRES (ZONA ORBICULARIS) ARE INTERNAL AND FORM A COLLAR ROUND THE FEMORAL NECK.

PARTLY BLENDED WITH THE PUBOFEMORAL AND ISCHIOFEMORAL LIGAMENTS BUT ARE NOT DIRECTLY ATTACHED TO BONE

EXTERNALLY, LONGITUDINAL FIBRES ARE MOST NUMEROUS IN THE ANTEROSUPERIOR REGION, REINFORCED BY THE ILIOFEMORAL LIGAMENT.

THE CAPSULE IS ALSO STRENGTHENED BY THE PUBOFEMORAL AND ISCHIOFEMORAL LIGAMENTS

EXTERNALLY IT IS ROUGH, COVERED BY MUSCLES AND SEPARATED FROM PSOAS MAJOR AND ILIACUS BY A BURSA

THE CAPSULAR ATTACHMENT TO THE FEMUR LIES DISTAL TO THE GROWTH PLATE OF THE FEMORAL HEAD BOTH ANTERIOR AND POSTERIORLY

THE UPPER FEMORAL EPIPHYSIS ENTIRELY INTRACAPSULAR

LIGAMENTS ILIOFEMORAL, PUBOFEMORAL,

ISCHIOFEMORAL, TRANSVERSE ACETABULAR AND THE LIGAMENTUM TERES.

ILIOFEMORAL LIGAMENT VERY STRONG AND SHAPED LIKE AN

INVERTED Y, LYING ANTERIORLY AND INTIMATELY BLENDED WITH THE CAPSULE.

APEX IS ATTACHED BETWEEN THE ANTERIOR INFERIOR ILIAC SPINE AND ACETABULAR RIM, ITS BASE TO THE INTERTROCHANTERIC LINE

ERECT POSTURE, A VERTICAL LINE THROUGH THE CENTER OF GRAVITY OF THE BODY FALLS SLIGHTLY BEHIND A LINE JOINING THE CENTERS OF THE TWO HIP JOINTS.

THE TENDANCY OF THE BODY TO FALL BACKWARDS ON THE HIP JOINTS IS RESISTED BY THE ILIOFEMORAL LIGAMENTS WHICH MAINTAIN THE ERECT POSTURE WITHOUT MUSCULAR ACTIVITY AT THESE JOINTS

PUBOFEMORAL LIGAMENT

TRIANGULAR, ITS BASE ATTACHING TO THE ILIOPUBIC EMINENCE, SUPERIOR PUBIC RAMUS, OBTURATOR CREST AND OBTURATOR MEMBRANE.

IT BLENDS DISTALLY WITH THE CAPSULE AND DEEP SURFACE OF THE MEDIAL ILIOFEMORAL LIGAMENT..

ISCHIOFEMORAL LIGAMENT

THICKENS THE BACK OF THE CAPSULE AND CONSISTS OF THREE DISTINCT PARTS

CENTRAL MEDIAL LATERAL

CENTRAL PART, THE SUPERIOR ISCHIOFEMORAL LIGAMENT

LATERAL AND MEDIAL INFERIOR ISCHIOFEMORAL LIGAMENTS EMBRACE THE POSTERIOR CIRCUMFERENCE OF THE FEMORAL NECK

TRANSVERSE ACETABULAR LIGAMENT

PART OF THE LABRUM BUT HAS NO CARTILAGE CELLS.

ITS STRONG, FLAT FIBRES CROSS THE ACETABULAR NOTCH FORMING A FORAMEN THROUGH WHICH VESSELS AND NERVES ENTER THE JOINT.

LIGAMENTUM TERES (LIGAMENT OF THE HEAD OF THE FEMUR)

TRIANGULAR, FLATTENED BAND APEX ATTACHED ANTEROSUPERIORLY IN

THE FOVEA ON THE FEMORAL HEAD BASE IS ATTACHED ON BOTH SIDES OF

THE ACETABULAR NOTCH, BETWEEN WHICH IT BLENDS WITH THE TRANSVERSE LIGAMENT.

IT ALSO RECEIVES WEAKER CONTRIBUTIONS FROM THE MARGINS OF THE ACETABULAR FOSSA.

ENSHEATHED BY SYNOVIAL MEMBRANE,

SYNOVIAL MEMBRANE LINES INNER PORTION OF CAPSULE AND

NON ARTICULAR STRUCTURES

THE SYNOVIAL MEMBRANE COVERS THE INTRACAPSULAR PART OF THE FEMORAL NECK.

THEN PASSES TO THE INTERNAL SURFACE OF THE CAPSULE TO COVER THE ACETABULAR LABRUM, LIGAMENTUM TERES AND FAT IN THE ACETABULAR FOSSA.

IT IS THIN ON THE DEEP SURFACE OF THE ILIOFEMORAL LIGAMENT WHERE IT IS COMPRESSED AGAINST THE FEMORAL HEAD AND SOMETIMES IS EVEN ABSENT HERE.

BLOOD SUPPLY

OBTURATOR ARTERY 2 CIRCUMFLEX FEMORAL ARTERIES 2 GLUTEAL ARTERIES

OBTURATOR ARTERY

BRANCH OF THE INTERNAL ILIAC ARTERY

GIVES RISE TO AN ACETABULAR BRANCH AND SUPPLIES THE FAT IN THE ACETABULAR FOSSA.

MEDIAL CIRCUMFLEX FEMORAL ARTERY

ARISES FROM THE PROFUNDA FEMORIS THREE BRANCHES

ACENDING TRANSVERSE TERMINAL

LATERAL CIRCUMFLEX ARTERY ARISES FROM THE PROFUNDA FEMORIS HAS THREE BRANCHES

ACENDING TRANSVERSE DECENDING

SUPERIOR GLUTEAL ARTERY ARISES FROM THE POSTERIOR BRANCH

OF THE INTERNAL ILIAC ARTERY

TWO DIVISIONS SUPERFICIAL DEEP—TAKES PART IN TROCHANTERIC

ANASTOMOSIS

INFERIOR GLUTEAL ARTERY ANTERIOR BRANCH OF THE INTERNAL

ILIAC ARTERY

6 DIVISIONS: ARTICULAR BRANCHES OF THE HIP JOINT CRUCIATE ANASTOMOTIC BRANCHES

SUPERIOR GLUTEAL ARTERY SUPPLIES THE UPPER PART OF THE ACETABULUM

INFERIOR GLUTEAL ARTERY SUPPLIES THE INFERIOR AND POSTERIOR PART OF THE ACETABULUM AND THE CAPSULE

BLOOD SUPPLY OF THE HEAD OF FEMUR

EXTRACAPSULAR ARTERIAL RING AT THE BASE OF THE FEMORAL NECK;  FORMED POSTERIORLY BY BRANCH OF MFCA  FORMED ANTERIORLY BY BRANCHES OF LFCA;  SUPERIOR & INFERIOR GLUTEAL

ARTERY HAVE MINOR CONTRIBUTIONS; 

ASCENDING CERVICAL BRANCHES 

         - THESE GIVE RISE TO RETINACULAR ARTERIES         - GIVES RISE TO SUBSYNOVIAL INTRA ARTICULAR RING 

ARTERY OF LIGAMENTUM TERES

DERIVED FROM OBTURATOR OR MFCA

INADEQUATE TO SUPPLY FEMORAL HEAD WITH DISPLACED FRACTURES

FORMS THE MEDIAL EPIPHYSEAL VESSELS

ONLY SMALL & VARIABLE AMOUNT OF THE FEMORAL HEAD IS NOURISHED BY ARTERY OF LIGAMENTUM TERES

EPIPHYSEAL BLOOD SUPPLY: 

EPIPHYSEAL ARTERIAL BRANCHES ARISE AS ARTERIES OF SUBSYNOVIAL INTRAARTICULAR RING

TWO GROUPS OF EPIPHYSEAL ARTERIES: LATERAL & INFERIOR                      

METAPHYSEAL BLOOD SUPPLY:

ARISES FROM EXTRACAPSULAR ARTERIAL RING

ARISE FROM BRANCHES OF ASCENDING CERVICAL ARTERIES- SUBSYNOVIAL INTRA ARTICULAR RING

NERVE SUPPLY OF THE HIP JOINT

FEMORAL NERVE

ANTERIOR DIVISION OF THE OBTURATOR NERVE

NERVE TO QUADRATUS FEMORIS

SUPERIOR GLUTEAL NERVE

FEMORAL NERVE FORMED BY THE DORSAL DIVISIONS OF THE

ANTERIOR PRIMARY RAMI OF SPINAL NERVES L2,L3,L4

GIVES RISE TO MUSCULAR/CUTANEOUS/ ARTICULAR BRANCHES

ARTICULAR BRANCH-NERVE TO RECTUS FEMORIS SUPPLIES THE HIP JOINT

OBTURATOR NERVE

VENTRAL DIVISIONS OF THE ANTERIOR PRIMARY RAMI OF SPINAL NERVES L2,L3,L4

WITHIN THE OBTURATOR CANAL THE NERVE DIVIDES INTO ANTERIOR AND POSTERIOR DIVISONS

BRANCH TO THE HIP JOINT ARISES FROM THE ANTERIOR DIVISON

NERVE TO QUADRATUS FEMORIS

ARISES FROM THE SACRAL PLEXUS (L4,L5,S1)

SUPPLIES THE QUADRATUS FEMORIS, GEMELLUS INFERIOR AND THE HIP JOINT

SUPERIOR GLUTEAL NERVE

ARISES FROM THE SACRAL PLEXUS( L4,L5,S1)

SUPPLIES THE GLUTEUS MEDIUS, GLUTEUS MINIMUS AND TENSOR FASCIA LATAE AND THE HIP JOINT

MOVEMENTS MUSCLES NERVE SUPPLY

FLEXION ILIACUS AND PSOAS MAJOR

LUMBAR VENTRAL RAMI

RECTUS FEMORIS

FEMORAL

SARTORIUS FEMORALTENSOR FACIA LATA

SUPERIOR GLUTEAL

PECTINEUS FEMORALADDUCTORS LONGUS AND BREVIS

OBTURATOR

MOVEMENTS MUSCLES NERVE SUPPLY

EXTENSION GLUTEUS MAXIMUS

INFERIOR GLUTEAL

SEMIMEMBRANOSUS

SCIATIC(TIBIAL PART)

SEMITENDINOSUS

SCIATIC(TIBIAL PART)

BICEPS FEMORIS LONG HEAD

SCIATIC(TIBIAL PART)

ADDUCTOR MAGNUS ISCHIAL PART

SCIATIC(TIBIAL PART)

MOVEMENTS MUSCLES NERVE SUPPLY

ADDUCTION ADDUCTORS LONGUS, BREVIS AND MAGNUS

OBTURATOR

GRACILIS OBTURATOR

PECTINEUS FEMORAL

QUADRATUS FEMORIS

L4/5 AND S1 VENTRAL RAMI

MOVEMENTS MUSCLES NERVE SUPPLY

ABDUCTION GLUTEUS MEDIUS AND MINIMUS

SUPERIOR GLUTEAL

TENSOR FASCIA LATA

SUPERIOR GLUTEAL

PIRIFORMIS L5S1/2 VENTRAL RAMI

OBTURATOR INTERNUS IN FLEXION

L5S1/2 VENTRAL RAMI

MOVEMENTS MUSCLES NERVE SUPPLY

MEDIAL ROTATION

TENSOR FASCIA LATA

SUPERIOR GLUTEAL

GLUTEUS MINIMUS

SUPERIOR GLUTEAL

GLUTEUS MEDIUS ANT FIBERS

SUPERIOR GLUTEAL

MOVEMENTS MUSCLES NERVE SUPPLYLATERAL ROTATION

SARTORIUS FEMORALGLUTEUS MAXIMUS

INFERIOR GLUTEAL

OBTURATOR INTERNUS AND GEMELLI

L5S1/2 VENTRAL RAMI

OBTURATOR EXTERNUS

OBTURATOR

QUADRATUS FEMORIS

L4/5;S1 VENTRAL RAMI

PIRIFORMIS IN FLEXION

L5S1/2 VENTRAL RAMI

REFERENCE

GRAY’S ANATOMY CUNNINGHAM’S MANUAL OF PRACTICAL

ANATOMY