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Hip Joint

The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thigh bone or femur and the pelvis join to form the hip joint.

Any injury or disease of the hip will adversely affect the joint's range of motion and ability to bear weight.

The hip joint is made up of the following:

  • Bones and joints
  • Ligaments of the joint capsule
  • Muscles and tendons
  • Nerves and blood vessels that supply the bones and muscles of the hip

Bones and Joints

The hip joint is the junction where the hip joins the leg to the trunk of the body. It is comprised of two bones: the thigh bone or femur and the pelvis which is made up of three bones called ilium, ischium, and pubis.  The ball of the hip joint is made by the femoral head while the socket is formed by the acetabulum. The Acetabulum is a deep, circular socket formed on the outer edge of the pelvis by the union of three bones: ilium, ischium, and pubis. The lower part of the ilium is attached by the pubis while the ischium is considerably behind the pubis. The stability of the hip is provided by the joint capsule or acetabulum and the muscles and ligaments which surround and support the hip joint.

The head of the femur rotates and glides within the acetabulum. A fibrocartilagenous lining called the labrum is attached to the acetabulum and further increases the depth of the socket.

The femur or thigh bone is one of the longest bones in the human body. The upper part of the thigh bone consists of the femoral head, femoral neck, and greater and lesser trochanters. The head of the femur joins the pelvis (acetabulum) to form the hip joint. Next, to the femoral neck, there are two protrusions known as greater and lesser trochanters which serve as sites of muscle attachment.

Articular cartilage is the thin, tough, flexible, and slippery surface lubricated by synovial fluid that covers the weight-bearing bones of the body. It enables smooth movements of the bones and reduces friction.

Ligaments

Ligaments are fibrous structures that connect bones to other bones. The hip joint is encircled with ligaments to provide stability to the hip by forming a dense and fibrous structure around the joint capsule. The ligaments adjoining the hip joint include:

  • Iliofemoral ligament: This is a Y-shaped ligament that connects the pelvis to the femoral head at the front of the joint. It helps in limiting the over-extension of the hip.
  • Pubofemoral ligament: This is a triangular shaped ligament that extends between the upper portion of the pubis and the iliofemoral ligament. It attaches the pubis to the femoral head.
  • Ischiofemoral ligament: This is a group of strong fibers that arise from the ischium behind the acetabulum and merge with the fibers of the joint capsule.
  • Ligamentum teres: This is a small ligament that extends from the tip of the femoral head to the acetabulum. Although it has no role in hip movement, it does have a small artery within that supplies blood to a part of the femoral head.
  • Acetabular labrum: The labrum is a fibrous cartilage ring which lines the acetabular socket. It deepens the cavity, increasing the stability and strength of the hip joint.

Muscles and Tendons

A long tendon called the iliotibial band runs along the femur from the hip to the knee and serves as an attachment site for several hip muscles including the following:

  • Gluteals: These are the muscles that form the buttocks. There are three muscles (gluteus minimus, gluteus maximus, and gluteus medius) that attach to the back of the pelvis and insert into the greater trochanter of the femur.
  • Adductors: These muscles are located in the thigh which helps in adduction, the action of pulling the leg back towards the midline.
  • Iliopsoas: This muscle is located in front of the hip joint and provides flexion. It is a deep muscle that originates from the lower back and pelvis and extends up to the inside surface of the upper part of the femur.
  • Rectus femoris: This is the largest band of muscles located in front of the thigh. They also are hip flexors.
  • Hamstring muscles: These begin at the bottom of the pelvis and run down the back of the thigh. Because they cross the back of the hip joint, they help in extension of the hip by pulling it backward.

Nerves and Arteries

Nerves of the hip transfer signals from the brain to the muscles to aid in hip movement. They also carry the sensory signals such as touch, pain, and temperature back to the brain.

  • The main nerves in the hip region include the femoral nerve in the front of the femur and the sciatic nerve at the back. The hip is also supplied by a smaller nerve known as the obturator nerve.
  • In addition to these nerves, there are blood vessels that supply blood to the lower limbs. The femoral artery, one of the largest arteries in the body, arises deep in the pelvis and can be felt in front of the upper thigh.

Hip Movements

All of the anatomical parts of the hip work together to enable various hip movements. Hip movements include flexion, extension, abduction, adduction, circumduction, and hip rotation.

Avulsion Fractures of the Pelvis

Avulsion Fractures of the Pelvis

Avulsion fractures of the pelvis is an injury that occurs when a tendon or ligament pulls off a piece of bone from the hip. This results in a part of the pelvic (hip) bone breaking away from the main part of the bone.

Gluteus Tendon Tear

Gluteus Tendon Tear

The gluteal muscles (situated in the buttocks) are necessary for the stability and movement of the hip joints. The tendons of two gluteal muscles (gluteus medius and gluteal minimus) are attached at the outer hip region and are often called the “rotator cuff of the hip.”

Hip Pain

Hip Pain

Hip pain, one of the common complaints, may not always be felt precisely over the hip joint rather in and around the hip joint. The cause for pain is multifactorial and the exact position of your hip pain suggests the probable cause or underlying condition causing it.

Snapping Hip Syndrome

Snapping Hip Syndrome

Snapping hip syndrome is a condition in which you hear or feel a snapping sound in the hip when you swing your legs, run, walk or get up from a chair. The sound can be experienced in the back, front or side of the hip.

Femoroacetabular Impingement

Femoroacetabular Impingement

Femoroacetabular impingement (FAI) is a condition characterized by excessive friction in the hip joint from the presence of bony irregularities. These cause pain and decreased range of hip motion.

Hip Labral Tear

Hip Labral Tear

A hip labral tear is an injury to the labrum, the cartilage that surrounds the outside rim of your hip joint socket.

Hip Abductor Tears

Hip Abductor Tears

Hip abductors are a major group of muscles found in the buttocks. It includes the gluteus maximus, gluteus medius, gluteus minimus, and tensor fascia lata muscles.

Developmental Dysplasia

Developmental Dysplasia

Developmental dysplasia of the hip (DDH) or hip dysplasia is a condition that is seen in infants and young children because of developmental problems in the hip joint.

Hamstring Injuries

Hamstring Injuries

The hamstring is a group of three muscles that run along the back of the thigh from the hip to the knee. Hamstring injuries occur when these muscles are strained or pulled.

Gluteus Tendon Repair

Gluteus Tendon Repair

The gluteal muscles (situated in the buttocks) are necessary for the stability and movement of the hip joints. The tendons of two gluteal muscles (gluteus medius and gluteal minimus) are attached at the outer hip region and are often called the “rotator cuff of the hip.”

Hip Preservation Surgery

Hip Preservation Surgery

The hip is a ball and socket joint comprising of the femur (thigh bone) and the pelvic bone. The head of the femur (ball) articulates with a cavity (socket) called the acetabulum in the pelvic bone.

Hip Labral Repair

Hip Labral Repair

Labrum is a ring of strong fibrocartilaginous tissue lining around the socket of the hip joint. Labrum serves many functions where it acts as a shock absorber, lubricates the joint, and distributes the pressure equally.

Hip Arthroscopy

Hip Arthroscopy

Arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into a joint to check for any damage and repair it simultaneously.

Proximal Hamstring Repair

Proximal Hamstring Repair

Hamstring injuries primarily occur when the muscle is exposed to extreme strain; when it is stretched beyond its ability or when it must withstand a sudden load.

Hip Arthroscopy - Supine Position

Hip Arthroscopy - Supine Position

Arthroscopy, also referred to as keyhole or minimally invasive surgery, is a procedure in which an arthroscope is inserted into a joint to check for any damage and to repair the problem at the same time.

Hip Reconstruction

Hip Reconstruction

Hip reconstruction is a surgery to repair or replace a damaged hip joint that causes pain and limits your movement.

Ischiofemoral Impingement Decompression – Procedure

Ischiofemoral Impingement Decompression – Procedure

Ischiofemoral impingement decompression is a surgery performed to relieve hip pain caused by entrapment or compression of soft tissue in the ischiofermoral space present between the upper part of the thigh bone and the lower back part of the hip bone.