Hip osteo/arthro

define osteokinematics

the physiologic motion that occurs

• what we are measuring w/ a goni

define arthrokinematics

the accessory motion that is occurring w/in the joint

if both the osteo and arthro are limited, what deficit is present

joint mobility

if the osteo are limited but the arthro are normal, what deficit is present

tissue extensibility

What hip motions occur in the sagittal plane

flex/ext

What hip motions occur in the frontal plane

abd/add

What hip motions occur in the horizontal plane

ER/IR

anatomy of the hip joint

concave acetabulum articulates w/ convex femoral head

normal ROM for flexion

120-140

normal ROM for ext

20-30

normal ROM for ER

35-50

normal ROM for IR

30-45

normal ROM for abd

40-55

normal ROM for add

20-25

arthrokinematics of hip flex

ant roll, post slide

arthrokinematics of hip ext

post roll, ant slide

arthrokinematics of hip ER

post roll, ant slide

arthrokinematics of hip IR

ant roll, post lide

arthrokinematics of hip abd

sup/lat roll, inf/med slide

arthrokinematics of hip add

inf/med roll, sup/lat slide

Why do we need to assess hip rotation in both flex and ext positions

different tensions on the hip capsule in certain positions

arthrokinematics of hip flex at 90

inf glide

arthrokinematics of hip ext at 90

sup glide

arthrokinematics of hip IR at 90

inf glide

arthrokinematics of hip ER at 90

superior glide

arthrokinematics of hip abd at 90

ant glide

arthrokinematics of hip add at 90

post glide

when performing MSF, which hip is performing IR

ipsilat

when performing MSF, which hip is performing ER

contralat

how are the posterior and anterior capsules tested

mob type motion

define the angle of inclination

angle in the frontal plane between the femoral neck and femoral shaft

normal angle of inclincation

125

angle of inclincation indicating coxa vara

<125

angle of inclincation indicating coxa valga

>125

angle of inclination at birth

165-170

how does the angle of inclination change over time

as muscles pull and load femoral neck, especially w/ walking

angle of inclination adjustments between 2-8 y/o

~2 degrees per year

what affect can coxa vara have on the knee

genu valgum

what affect can coxa valgum have on the knee

genu vara

define femoral torsion

twisting of the femoral shaft

how is femoral torsion measured

axis of femoral head and neck in comparison to the transverse axis of femoral condyles

what is needed to measure femoral torsion

imaging

what is femoral version

relationship between proximal femur and the acetabulum

what is femoral version at birth

~40 ante

normal femoral version

8-15

When is normal anteversion reached

around 16 y/o

define excessive anteversion

greater than norm

define retroversion

less than norm

who is more likely to have anteverions

women

characteristic of excessive anteversion

toeing in gait

would you ant mob someone w/ excessive anteverion

no because they head of femur is already positioned too far anteriorly in acetabulum → risk sublux

Characteristic of retroversion

toeing out gait

how do you know when its femoral version and when its a limitation

excessive anteversion = difference between IR and ER is 45+

purpose of craig’s test

assess for femoral anteversion or retroversion

procedure for craigs test

palp greater troch

rotate hip until troch most lateral

measure hip rotation angle

normal IR for craig test

8-15

craig test indicating excessive anteversion

>15 IR

craig test indicating retroversion

<8 IR or any ER