Anatomy of Hip Joint

ANATOMY OF HIP JOINT
The hip joint is a ball and socket synovial joint, formed by an articulation between the
pelvic acetabulum and the head of the femur.
It forms a connection from the lower limb to the pelvic girdle, and thus is designed for
stability and weight-bearing – rather than a large range of movement.
Here, we shall look at the anatomy of the hip joint – its articulating surfaces, ligaments and
neurovascular supply.
Structures of the Hip Joint
Articulating Surfaces
The hip joint consists of an articulation between the head of femur and acetabulum of the
pelvis.
The acetabulum is a cup-like depression located on the inferolateral aspect of the pelvis.
Its cavity is deepened by the presence of a fibrocartilaginous collar – the acetabular
labrum. The head of femur is hemispherical, and fits completely into the concavity of the
acetabulum.
Both the acetabulum and head of femur are covered in articular cartilage, which is thicker
at the places of weight bearing.
The capsule of the hip joint attaches to the edge of the acetabulum proximally. Distally, it
attaches to the intertrochanteric line anteriorly and the femoral neck posteriorly.
Ligaments
The ligaments of the hip joint act to increase stability. They can be divided into two groups
– intracapsular and extracapsular:
Intracapsular
The only intracapsular ligament is the ligament of head of femur. It is a relatively small
structure, which runs from the acetabular fossa to the fovea of the femur.
It encloses a branch of the obturator artery (artery to head of femur), a minor source of
arterial supply to the hip joint.
Extracapsular
There are three main extracapsular ligaments, continuous with the outer surface of the hip
joint capsule:
Iliofemoral ligament – arises from the anterior inferior iliac spine and then bifurcates
before inserting into the intertrochanteric line of the femur.
It has a ‘Y’ shaped appearance, and prevents hyperextension of the
hip joint. It is the strongest of the three ligaments.
Pubofemoral – spans between the superior pubic rami and the intertrochanteric line of
the femur, reinforcing the capsule anteriorly and inferiorly.
It has a triangular shape, and prevents excessive abduction and extension.
Ischiofemoral– spans between the body of the ischium and the greater trochanter of the
femur, reinforcing the capsule posteriorly.
It has a spiral orientation, and prevents hyperextension and holds the femoral head
in the acetabulum.
Neurovascular Supply
The arterial supply to the hip joint is largely via the medial and lateral circumflex femoral
arteries – branches of the profunda femoris artery (deep femoral artery). They anastomose
at the base of the femoral neck to form a ring, from which smaller arteries arise to supply
the hip joint itself.
The medial circumflex femoral artery is responsible for the majority of the arterial supply
(the lateral circumflex femoral artery has to penetrate through the thick iliofemoral
ligament). Damage to the medial circumflex femoral artery can result in avascular necrosis
of the femoral head.
The artery to head of femur and the superior/inferior gluteal arteries provide some
additional supply.
The hip joint is innervated primarily by the sciatic, femoral and obturator nerves. These
same nerves innervate the knee, which explains why pain can be referred to the knee from
the hip and vice versa.
Stabilising Factors
The primary function of the hip joint is to weight-bear. There are a number of factors that
act to increase stability of the joint.
The first structure is the acetabulum. It is deep, and encompasses nearly all of the head of
the femur. This decreases the probability of the head slipping out of the acetabulum
(dislocation).
There is a horseshoe shaped fibrocartilaginous ring around the acetabulum which

increases its depth, known as the acetabular labrum. The increase in depth provides a
larger articular surface, further improving the stability of the joint.
The iliofemoral, pubofemoral and ischiofemoral ligaments are very strong, and along
with the thickened joint capsule, provide a large degree of stability. These ligaments have a
unique spiral orientation; this causes them to become tighter when the joint is extended.
In addition, the muscles and ligaments work in a reciprocal fashion at the hip joint:
Anteriorly, where the ligaments are strongest, the medial flexors (located anteriorly) are
fewer and weaker.
Posteriorly, where the ligaments are weakest, the medial rotators are greater in number
and stronger – they effectively ‘pull’ the head of the femur into the acetabulum.
Movements and Muscles
The movements that can be carried out at the hip joint are listed below, along with the
principle muscles responsible for each action:
Flexion – iliopsoas, rectus femoris, sartorius, pectineus
Extension – gluteus maximus; semimembranosus, semitendinosus and biceps femoris (the

hamstrings)
Abduction – gluteus medius, gluteus minimus, piriformis and tensor fascia lata.
Adduction – adductors longus, brevis and magnus, pectineus and gracilis
Lateral rotation – biceps femoris, gluteus maximus, piriformis, assisted by the obturators,
gemilli and quadratus femoris.
Medial rotation – anterior fibres of gluteus medius and minimus, tensor fascia latae
The degree to which flexion at the hip can occur depends on whether the knee is flexed –
this relaxes the hamstring muscles, and increases the range of flexion.
Extension at the hip joint is limited by the joint capsule and the iliofemoral ligament. These
structures become taut during extension to limit further movement.
Submitted by :
Sneha Parveen
BPO2018

Anatomy of Hip Joint

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Anatomy of Hip Joint

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ANATOMY OF HIP JOINT

Structures of the Hip Joint

There is a horseshoe shaped fibrocartilaginous ring around the acetabulum which

Movements and Muscles

Flexion – iliopsoas, rectus femoris, sartorius, pectineus

Extension – gluteus maximus; semimembranosus, semitendinosus and biceps femoris (the

Adduction – adductors longus, brevis and magnus, pectineus and gracilis

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