Biomechanics of Hip Joint

By DEVADRI DEY & OBAID UR REHMAN

MPO 1st Year/2nd Batch
Mobility India
• Articular Surfaces:
Proximal articular surface • Kinetics of Hip Joint:
Distal articular surface Hip free body analysis
Center Edge Angle of the Acetabulum
Acetabular Anteversion • Hip Joint Compression in Bilateral
• Hip Joint Compression in Unilateral
• Stability of Hip Joint: • Hip Joint Lateral Lean Compression
Ligaments and Connective Tissues

• Kinematics of Hip Joint:

Osteokinematic
Arthrokinematics
Introduction
• The hip joint, or coxofemoral joint, is the articulation of the acetabulum of
the pelvis and the head of the femur.
• These two segments form a diarthrodial ball-and-socket joint with three
degrees of freedom:
- flexion/extension in the sagittal plane,
- abduction/adduction in the frontal plane,
- medial lateral rotation in the transverse plane
• The primary function of the hip joint is to support the weight of the head,
arms, and trunk(HAT) in:
- static erect posture
- dynamic postures such as ambulation, running, and stair climbing
 Articular Surfaces
Proximal articular surface:
• Socket:
- A horseshoe-shaped portion of the periphery of the
acetabulum (the lunate surface) is covered with hyaline
cartilage and articulates with the head of the femur
- The acetabular notch is spanned by a fibrous band, the
transverse acetabular ligament, that connects the two ends
of the horseshoe.

Distal articular surface:

• The head of femur:
- Fovea or fovea capitis
- Ligament of the head of the femur
(ligamentum teres)
 • The acetabulum is deepened by the fibrocartilaginous
acetabular labrum, which surrounds the periphery. The
acetabular fossa is nonarticular; the femoral head does not
contact this surface.

Center Edge Angle of the Acetabulum

• A line connecting the lateral rim of the acetabulum and the
center of the femoral head which forms an angle known as
center edge (CE) angle or the angle of Wiberg.
• Average CE angle is 38 and 35 in men and women
respectively.

Acetabular Anteversion
• The magnitude of anterior orientation of the acetabulum may
be referred to as the angle of acetabular anteversion.
• Average value to be 18.5 for men and 21.5 for women.
Acetabular Labrum
• The labrum is attached to the periphery of the
acetabulum by a zone of calcified cartilage with a
well-defined tidemark.
• The acetabular labrum not only deepens the socket but
also increases the concavity of the acetabulum through
its triangular shape and grasps the head of the femur to
maintain contact with the acetabulum.
• the labrum may also enhance joint lubrication if the
labrum adequately fits the femoral head.
 Stability of Hip Joint Ligaments
• Hip joint stability is attributed to the articulation of the convex  Intracapsular
femoral head (ball) into the concave acetabulum (socket)
with additional reinforcement arising from the articular o Ligament of Head of Femur
capsule and surrounding muscles and ligaments. • Attached the head of femur to the acetabulum fossa

 Extracapsular

o Iliofemoral ligament
• Iliac spine to the intertrochanter line
• Y shaped
• Prevents hyperextension
• Strongest of 3 ligaments

o Pubofemoral ligament
• Superior pubic rami and intertrochanteric line
• Reinforces the capsule
• Triangular shape
• Prevents excessive abduction and extension

o Ischiofemoral ligament
• Ischium and greater trochanter
• Reinforcing the capsule posteriorly
• Spiral orientation
• Prevents hyperextension
• Holds the femoral head in the acetabulum
 Kinematics of Hip Joint
• Osteokinematics describes clear movements of bones which are visible from the outside.
• There are two Osteokinematics can be seen in hip joint:
1. Femoral-on-pelvic Osteokinematics
2. Pelvic-on-femoral Osteokinematics

The osteokinematics of the right hip joint. Femoral-on-

pelvic and pelvic-on-femoral rotations occur in three
planes. The axis of rotation for each plane of
movement is shown as a colored dot, located at the
center of the femoral head.
A, Side view shows sagittal plane rotations around a
medial-lateral axis of rotation.
B, Front view shows frontal plane rotations around an
anterior-posterior axis of rotation.
C, Top view shows horizontal plane rotations around a
longitudinal, or vertical, axis of rotation.
Femoral-on-pelvic Osteokinematics
Rotation of the Femur in the Sagittal Plane: On average, with the knee flexed, the hip flexes to about 120 degrees.
Full hip flexion slackens the three primary capsular ligaments but stretches the inferior capsule and muscles such as the gluteus maximus.
With the knee fully extended, hip flexion is typically limited to 70 to 80 degrees by increased tension in the hamstring muscles.

The hip normally extends about 20 degrees beyond the neutral position. Full hip extension increases the passive tension throughout the
capsular ligaments—especially the iliofemoral ligament and the hip flexor muscles. When the knee is fully flexed during hip extension,
passive tension in the stretched rectus femoris, which crosses both the hip and the knee, reduces hip extension to about the neutral
position.
Rotation of the Femur in the Frontal Plane: The hip abducts
on average about 40 degrees, limited primarily by the
pubofemoral ligament and the adductor muscles.
The hip adducts about 25 degrees beyond the neutral
position. In addition to interference with the contralateral
limb, passive tension in stretched hip abductor muscles,
iliotibial band, and superior fibers of the ischiofemoral
ligament limits full adduction.

Rotation of the Femur in the Horizontal Plane: On average, the

hip internally rotates about 35 degrees from the neutral
position. With the hip in extension, maximal internal rotation
elongates the external rotator muscles, such as the piriformis,
and parts of the ischiofemoral ligament.
The extended hip externally rotates on average about 45
degrees. Excessive tension in the lateral fasciculus of the
iliofemoral ligament can limit full external rotation. In addition,
external rotation can be limited by excessive tension in any
internal rotator muscle.
Pelvic-on-femoral Osteokinematics:
Pelvic Rotation in the Sagittal Plane: The anterior tilt of the pelvis occurs about a medial-lateral axis of rotation
through both femoral heads. While sitting with 90 degrees of hip flexion, the normal adult can perform about 30
degrees of additional pelvic-on-femoral hip flexion before being restricted by a completely extended lumbar spine.
During standing (and with knees fully extended), however, the more elongated hamstrings are more likely to resist an
anterior pelvic tilt, but the amount of resistance is usually insignificant unless the muscle is physiologically impaired
and generating extreme resistance to elongation. The hips can be extended about 10 to 20 degrees from the 90-
degree sitting posture via a posterior tilt of the pelvis.
Pelvic Rotation in the Frontal Plane: Pelvic-on-femoral rotation in the frontal and horizontal planes is best described assuming a person is
standing on one limb. The weight-bearing extremity is referred to as the support hip. Abduction of the support hip occurs by raising or
“hiking” the iliac crest on the side of the nonsupport hip. Pelvic-on-femoral hip abduction is restricted to about 30 degrees, primarily
because of the natural limits of lateral bending in the lumbar spine.
Adduction of the support hip occurs by a lowering of the iliac crest on the side of the nonsupport hip. This motion causes a slight lateral
concavity within the lumbar region on the side of the adducted hip. A hypomobile lumbar spine and/or reduced extensibility in the iliotibial
band or hip abductor muscles.
Pelvic Rotation in the Horizontal Plane: Pelvic-on-femoral rotation occurs in the horizontal plane about a longitudinal
axis of rotation. Internal rotation of the support hip occurs as the iliac crest on the side of the nonsupport hip rotates forward
in the horizontal plane. During external rotation, in contrast, the iliac crest on the side of the nonsupport hip rotates
backward in the horizontal plane. If the pelvis is rotating beneath a relatively stationary trunk, the lumbar spine must rotate
(or twist) in the opposite direction as the rotating pelvis. The small amount of axial rotation normally permitted in the
lumbar spine significantly limits the full expression of horizontal plane rotation of the support hip. The full potential of
pelvic-on-femoral rotation requires that the lumbar spine and trunk follow the rotation of the pelvis—a movement strategy
more consistent with an ipsidirectional lumbopelvic rhythm.
• Athrokinematics is the general term for the specific movements of joint surfaces.
• During hip motion, the nearly spherical femoral head normally remains snugly seated within the confines of the
acetabulum. The steep walls of the acetabulum, in conjunction with the tightly fitting acetabular labrum, limit significant
translation between the joint surfaces. Hip arthrokinematics are based on the traditional convex-on-concave or concave-
on-convex principles.
• A hip opened to enable visualization of the paths of articular motion shows abduction and adduction occur across the
longitudinal diameter of the joint surfaces. With the hip extended, internal and external rotation occur across the
transverse diameter of the joint surfaces. Flexion and extension occur as a spin between the femoral head and the
lunate surfaces of the acetabulum. The axis of rotation for this spin passes through the femoral head.
Kinetics of Hip Joint
• The line of gravity falls just posterior to the
axis for flexion/extension of the hip joint
• In the frontal plane during bilateral stance,
the superincumbent body weight is
transmitted through the sacroiliac joints
and pelvis to the right and left femoral
heads
• joint axis of each hip lies at an equal
distance from the line of gravity of HAT
• The gravitational moment arms for the
right hip(DR) and the left hip (DL) are equal
• Because the body weight (W) on each
femoral head is the same (WR= WL), the
magnitude of the gravitational torques
around each hip must be identical

• WR X DR =WL X DL

• The gravitational torques on the right and

left hips occur in opposite directions.

• The weight of the body acting around the

right hip tends to drop the pelvis down on
the left (right adduction moment),
whereas the weight acting around the left
hip tends to drop the pelvis down on the
right (left adduction moment)
Hip Free Body Analysis
 Hip free body analysis
Free body analysis diagram
W = gravitational force
weight of the body minus weight of ipsilateral extremity (or 5/6 body weight)
M = abductor muscle force
R = joint reaction force can reach 3 to 6 times body weight

Solving for Joint Reaction Force (R)

• Step 1: calculate My
Principle: sum of all moments equals 0
In this case, the moments are created by My and W Equation
assume A = 5cm and B = 12.5cm
(A x My) + (B x W) = 0
My = 2.5W
• Step 2: calculate Ry • Step 3: calculate R
Ry = My + W R = Ry / (cos 30°)
Ry = 2.5W + W R = 3.5W / (cos 30°)
R  4W
Ry = 3.5W
Hip Joint Compression in Bilateral
• Using a hypothetical case of someone weighing 825 N (~185 lb), the weight of HAT (2/3 body weight) will
be 550 N (~124 lb). Of that 550 N, half will presumably be distributed through each hip. Because we are
assuming no additional compressive force produced by hip muscle activity, the total hip joint compression at
each hip in bilateral stance is estimated to be 225 N (~50 lb);

= 2/3 x 825N
2

= 225N

that is, total hip joint compression through each hip in bilateral stance is one third of body weight.
Hip Joint Compression in Unilateral
The left leg has been lifted from the ground and the full
superimposed body weight is being supported by the right hip
joint. Rather than sharing the compressive force of the
superimposed body weight with the left limb, the right hip joint
must now carry the full burden. In addition, the weight of the non–
weightbearing left limb that is hanging on the left side of the pelvis
must be supported along with the weight of HAT.
Of the one-third portion of the body weight found in the lower
extremities, the nonsupporting limb must account for half of that,
or one sixth of the full body weight.

Right hip joint compressionbody weight = [2/3 x W] + [1/6 x W]

= [5/6 x W]
Hip Joint Lateral Lean Compression
• Subject weighing 825 N, let us assume that he can laterally lean to the right enough to bring the LoG within 2.5 cm
(0.025 m) of the right hip joint axis. The gravitational adduction torque would now be:

HATLL torqueadduction = [5/6 x (825 N)] x 0.25 m

=17.2 Nm
• If only 17.2 Nm of adduction torque were produced by the superimposed weight, the abductor force needed would be as
follows:
Torqueadduction : 17.5Nm = Fms x 0.05m
Fms = 17.5Nm
0.05m

= 343.75N
• The total hip joint compression in unilateral stance using the compensatory lateral lean would now be:
Total Hip Joint Compression= 343.75 N abductor joint compression +