Hip

3 major aspects of the hip?

Ilium

Pubis

Ischium

Angle of inclination

Angle between the longitudinal axis of the femoral neck to that of the femoral shaft in the
frontal plane

Coxa vara

Decrease in angle of inclination

Coxa valga

Increase in angle of inclination

5 functions of labrum (located within acetabular fossa)

Joint stability

Shock absorber

Joint lubricator

Pressure distributor

Reduces contact stress

Joint stability from labrum

Increases the surface area of the joint therefore allowing for a wider area of force distribution

Joint lubricator from labrum

Sealing mechanism keeps the synovial fluid in contact with articular cartilage

Pressure distributor from labrum

Obstructs fluid flow in and out of the joint through a sealing action (suction effect)

Where does labrum decrease contact stress between?

The acetabular and femoral cartilage

Open-packed position

(combined:)

Flexion

Abduction

External rotation

Closed-packed position

Full extension

Iliofemoral ligament (connects ilium to femur)

Stabilises anterior hip against anterior displacement

Prevents
hyper-extension

Inverted Y shaped

Pubofemoral ligament

Strengthens mainly the anterior & inferior hip
joint

Prevents over abduction of the joint

Triangular

Ischiofemoral ligament

Strengthens posterior
hip joint

Taut in internal
rotation, extension,
flexion and adduction

Contents of the femoral triangle

Femoral Nerve
Femoral Artery
Femoral Vein
Femoral canal (Empty space)
Lymphatics

What test tests hip flexor length?

Thomas test

What are 3 possible positive findings?

Iliopsoas tightness (thigh remains flexed)

Rectus femoris tightness (knee extension)

IT band tightness (abduction/external rotation)

What test tests for iliotibial band/tensor fasciae latae length test?

Ober’s test

Possible positive test finding?

IT band tightness/lack of flexibility (remains abducted)

How to measure hip flexion with a goniometer?

Supine patient, positioning the axis at the greater trochanter, aligning the movement arm with the femur’s lateral epicondyle and the stationary arm along the trunk.

Hip flexion is performed, 110-120 degrees.

ST approximate (if knee flexed)/ST stretch (if knee extended)

How to measure hip extension with a goniometer?

Patient lies prone, the axis is placed on the greater trochanter, the movement arm aligns with the lateral epicondyle of the femur, and the stationary arm aligns with the trunk.

Hip extension is performed, 10-15 degrees.

ST stretch end feel

How to measure hip internal rotation with a goniometer?

Patient sits with knee at 90°, axis on patella, stationary arm perpendicular to ground, movement arm along tibia.

Internal rotation is performed, 30-40 degrees.

ST stretch end feel

How to measure hip external rotation with a goniometer?

Patient sits with knee at 90°, axis on patella, stationary arm perpendicular to ground, movement arm along tibia.

External rotation is performed,40-60 degrees.

ST stretch end feel

How to measure hip adduction with a goniometer?

Patient lies supine; axis placed over the measured side’s ASIS, stationary arm aligned to opposite ASIS, movement arm to patella.

Opposite leg abducts to allow inward motion.

Hip adduction is performed, 30 degrees (red scale)

ST stretch approximation

How to measure hip abduction with a goniometer?

Patient lies supine; axis placed over the measured side’s ASIS, stationary arm aligned to opposite ASIS, movement arm to patella.

Hip abduction is performed, 30-50 degrees (red scale)

ST stretch