Anatomy and Biomechanics of the Hip

  • Kim, Yong-Sik (Department of Orthopaedic Surgery, Seoul Mary's Hospital, Medical College, The Catholic University of Korea) ;
  • Kwon, Soon-Yong (Department of Orthopaedic Surgery, St. Mary’s Hospital, Medical College, The Catholic University of Korea) ;
  • Han, Suk-Ku (Department of Orthopaedic Surgery, St. Paul’s Hospital, Medical College, The Catholic University of Korea)
  • Published : 2009.06.30

Abstract

The ball and socket structure of the hip joint allows a wide range of motion that is exceeded in no other joint of the body except the shoulder. At the same time, a remarkable degree of stability is provided by the close fit of the femoral head into the acetabulum and its deepening lip, the glenoid labrum, and by the support of the strongest capsular ligaments and the thickest musculature of the body. Of all the joints, the hip is most deeply situated. This relative inaccessibility increases the difficulty of diagnosing hip lesions, rendering thorough operative exposure of the joint arduous. Precise knowledge about the anatomy of the hip joint and its surrounding structures help orthopaedic surgeons diagnose and treat various diseases and trauma around the hip joint. An understanding of the biomechanics of the hip is vital to advancing the diagnosis and treatment of many pathologic conditions. Benefits from advances in hip biomechanics include the evaluation of joint function, the development of therapeutic programs for treatment of joint problems, procedures for planning reconstructive surgeries, and the design and development of total hip prostheses. Biomechanical principles also provide a valuable perspective to our understanding of the mechanism of injury to the hip, to femoroacetabular impingement, and to the etiology of degenerative hip disease.

Keywords

References

  1. Andriacchi TP, Galante JO, Belytschko TB and Hampton S. A stress analysis of femoral stem in total hip prosthesis. J Bone Joint Surg, 58-A: 618-624, 1976.
  2. Andriacchi TP and Strichland AB. Lower limb kinetics applied to the study of normal and abnormal walking Biomechanics of normal and pathological human articulating joints. In: Berme N, Engin AE, Correia Da Silva KM, eds. NATO ASI Series E. Dordrecht: Martiuns Nijhoff, 93; 83-98, 1983.
  3. Brand RA and Crowninshield RD. The effect of cane use on hip contact force. Clin Orthop, 147: 181-184, 1980.
  4. Bergmann G, Graichen F and Rohlmann A. Hip joint loading during walking and running measured in two patients. J Biomech, 26: 969-990, 1993. https://doi.org/10.1016/0021-9290(93)90058-M
  5. Bergmann G, Graichen F and Rohlmann A. Is staircase walking a risk for the fixation of hip implants- J Biomec, 28: 535-553, 1995. https://doi.org/10.1016/0021-9290(94)00105-D
  6. Berman AT, Quinn RH and Zarro VJ. Quantitative gait analysis in unilateral and bilateral total hip replacements. Arch Phys Med Rehab, 72: 190-193, 1991.
  7. Berzins A, Sumner DR and Andriacchi TP. Stem curvature and load angle influence the initial relative bone-implant motion of cementless femoral stems. J Orthop Res, 11: 758-769, 1993. https://doi.org/10.1002/jor.1100110518
  8. Brand RA and Crowninshield RD. The effect of cane use on hip contact force. Clin Orthop, 147: 181-184, 1980.
  9. Brand RA, Pederson DR, Davy DT, Kotzar GM, Heiple KG and Goldberg VM. Comparison of hip force calculation and measurements in the same patient. J Arthroplasty, 9: 45-51, 1994. https://doi.org/10.1016/0883-5403(94)90136-8
  10. Brand RA, Pederson DR and Friederich JA. The sensitivity of muscle force predictions to changes in physiologic cross-sectional area. J Biomech, 19: 589-596, 1986. https://doi.org/10.1016/0021-9290(86)90164-8
  11. Brown M, Hislop H, Waters RL and Porell D. Walking efficiency before and after total hip replacement. Phys Ther, 60: 1259-1263, 1980.
  12. Bryan JM, Tompkins G, Sumner DR, Berzins A and Galante JO. Quantifying proximal femoral bone loss following cementless total hip arthroplasty using dual energy x-ray absorptiometry. Trans ORS, 19: 580. 1994.
  13. Callaghan JJ, Rosenberg AG and Rubash HE. The adult hip. In: Wasielewski RC ed. The hip. 2nd ed. Philadelphia, Lippincott Williams & Wilkins: 51-67, 2007.
  14. Charnley J. Low friction arthroplasty of the hip: theory and practice. New York: Springer-Verlag, 1979.
  15. Clemente CD. Gray's anatomy. 30th A. ed. Lea & Febiger. 1986.
  16. Cochran GVB. A primer of orthopedic biomechnics. New York: Chrchuill Livingstone, 240-250, 1982.
  17. Davey DT, Kotzar GM, Brown RH, et al. Telemetric force measurements across the hip after total hip arthroplasty. J Bone Joint Surg, 70-A: 45-50, 1988.
  18. Delp SL, Komattu AV and Wixson RL. Superior displacement of the hip in total joint replacement: effects of prosthetic neck length, neck-stem angle, and anteversion angle on the moment-generating capacity of the muscles. J Orthop Res, 12: 860-869, 1994. https://doi.org/10.1002/jor.1100120614
  19. Delp SL and Maloney W. Effects of hip center location on the moment-generating capacity of the muscles. J Biomech, 26: 485-499, 1993. https://doi.org/10.1016/0021-9290(93)90011-3
  20. Engh CA, McGovern TF, Bobyn JD and Harris WH. A quantitative evaluation of periprosthetic bone remodeling after cementless total hip arthroplasty. J Bone Joint Surg, 74-A: 1009-1020, 1992.
  21. English TA and Kilvington M. In vivo records of hip loads using a femoral implant with telemetric output(a preliminary report). J Biomed Eng, 1: 111-115, 1979. https://doi.org/10.1016/0141-5425(79)90066-9
  22. Frankel VH and Nordin M. Basic biomechanics of the skeletal system. Philadelphia: Lea and Febiger, 1980.
  23. Greenwald AS. Biomechanics of the hip. In: The hip and its disorders. Steinberg M, ed. Philadelphia: WB Saunders; 49, 1991.
  24. Hampton SJ, Andriacchi TP and Galante JO. Threedimensional stress analysis of the femoral stem of a total hip prosthesis. J Biomech, 13: 433-448, 1980.
  25. Hodge WA, Andriacchi TP and Galante JO. A relationship between stem orientation and function following total hip arthroplasty. J Arthroplasty, 6: 229-235, 1991. https://doi.org/10.1016/S0883-5403(06)80169-5
  26. Hodge WA, Carlson KL, Fijan SM, et al. Contact pressures from an instrumented hip endoprosthesis. J Bone Joint Surg, 71-A: 1378-1385, 1989.
  27. Hurwitz DE, Chertack CC and Andriacchi TP. How gait changes in preoperative and postoperative patients with total hip replacements. Proceedings of the second North American Congress on Biomechanic, 313-314, 1992.
  28. Johnston RC, Brand RA and Crowninshield RD. Reconstruction of the hip. J Bone Joint Surg, 61-A: 639-652, 1979.
  29. Kim HJ. The Korean orthopaedic association. In: The hip lesion, 654-681, 2006.
  30. Kim YS, Callaghan JJ, Ahn PB and Brown TD. Fracture of the acetabulum during insertion of an oversized hemispheric component. J Bone Joint Surg, 77-A: 111-117, 1995.
  31. Krebs DE, Elbaum L, Riley PO, Hodge WA and Mann RW. Exercise and gait effects on in vivo hip contact pressures. Phys The, 71: 301-309, 1991.
  32. Long WT, Dorr LD, Healy B and Perry J. Functional recovery of noncemented total hip arthroplasty. Clin Orthop, 288: 73-77, 1993.
  33. Neumann DA and Cook TM. Effect of load and carrying position on the electromyographic activity of the gluteus medius muscle during walking. Phys Ther, 65: 305-311, 1985.
  34. Paul JP. Approaches to design:force actions transmitted by joints in the human body. Proceeds Research Society London Brain, 192: 163-172, 1976. https://doi.org/10.1098/rspb.1976.0004
  35. Pauwels F. Biomechanics of the normal and diseased hip. Springer-Verlag. 1976.
  36. Rydell NW. Forces acting on the femoral- head prosthesis: a study on strain gage supplied prostheses in living persons. Acta Orthop Scand (Suppl), 88: 3, 1966.
  37. Seireg A and Arvikar RJ. The prediction of muscular load sharing and joint forces in the lower extremities during walking. J Biomech, 8: 89-102, 1975. https://doi.org/10.1016/0021-9290(75)90089-5
  38. Stauffer RN, Smidt GL and Wadsworth JB. Clinical and biomechanical analysis of gait following Charnley total hip replacement. Clin Orthop, 99: 70-77, 1974. https://doi.org/10.1097/00003086-197403000-00008
  39. Trueta J and Harrision MH. The normal vascular supply of the femoral head in adult man. J Bone Joint Surg, 35-B: 442-461, 1953.
  40. Wadsworth JB, Smit GL and Johnston RC. Gait characteristics of subjects with hip disease. Phys Ther, 52: 829-839, 1972.