Page 103 - untitled

AAAC46 21/5/05 10:53 AM Page 102
46 The hip joint and gluteal region

Anterior inferior iliac spine Origins of rectus femoris
Iliofemoral ligament
Iliofemoral (Bigelow's) ligament
Fat pad
Greater trochanter Articular cartilage
Pubofemoral ligament

Lesser trochanter

Labrum
acetabulare
Fig.46.1
Ligamentum Cut edge of
The front of the hip joint
teres capsular
Pubofemoral ligament
ligament Sacrospinous
ligament
Transverse
ligament Sacrotuberous
ligament

Ischiofemoral
ligament
Obturator
membrane
Fig.46.2
The structures around the acetabulum

The hip joint (Figs 46.1, 46.2 and 46.5) femoral neck as retinacula. These fibres are of extreme importance as
• Type: the hip is a synovial ball and socket joint. The articulation is they carry with them a blood supply to the femoral head.
between the rounded femoral head and the acetabulum which, like the • Stability: the stability of the hip is dependent predominantly on bony
shoulder, is deepened at its margins by a fibrocartilaginous rimathe factors. Ligamentous stability is provided by three ligaments:
labrum acetabulare. The central and inferior parts of the acetabulum (a) Iliofemoral ligament (Bigelow’s ligament)ais inverted, Yshaped
are devoid of articulating surface. This region is termed the acetabular and strong. It arises from the anterior inferior iliac spine and
notch from which the ligamentum teres passes to the fovea on the inserts at either end of the trochanteric line. This ligament pre-
femoral head. The inferior margin below the acetabular notch is com- vents hyperextension at the hip.
pleted by the transverse acetabular ligament. (b) Pubofemoral ligamentaarises from the iliopubic junction and
• Capsule: the capsule of the hip joint is attached above to the acetabu- passes to the capsule over the trochanteric line where it attaches.
lar margin, including the transverse acetabular ligament. The capsule (c) Ischiofemoral ligamentafibres arise from the ischium and some
attaches to the femur anteriorly at the trochanteric line and to the bases encircle laterally to attach to the base of the greater trochanter.
of the trochanters. Posteriorly the capsule attaches to the femur at a The majority of the fibres, however, spiral and blend with the
higher levelaapproximately 1 cm above the trochanteric crest. The capsule around the neck of the femurathe zona orbicularis.
capsular fibres are reflected from the lower attachment upwards on the

102 Lower limb