Note: To access the videos accompanying this report, visit the August issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Current Concepts With Video IllustrationA Clinically Relevant Review of Hip Biomechanics
Section snippets
Functional Anatomy and Kinematics
The hip effectively acts as a multi-axial ball-and-socket joint upon which the upper body is balanced during stance and gait. Stability of this joint is critical to allow motion while supporting the forces encountered during daily activity. Nearly all motion between the femoral head and acetabulum is rotational, with no detectable translation because of the congruency of the articulating surfaces.3, 4 The range of motion required in the hip during everyday tasks, such as rising from a chair,
General Biomechanics
The femoroacetabular joint is unique in the fact that it is never fully unloaded during daily activities. Although the duration of maximum loads experienced by the articular surfaces of the hip may be short, there is a residual compressive force acting across the joint at all times, with an average magnitude approximately equal to the body weight.27 Pauwels28 defined the forces acting around the hip and the moments required to balance the pelvis. The joint reactive force is the compressive
Pathologic Biomechanics and Surgical Intervention
Biomechanics in the development or as a result of pathologic conditions in the hip may result from anatomic alteration, congenital deficiency, injury, or degeneration. Familiarity with the biomechanical causes of various pathologies of the hip and the consequences of anatomic variations of the structures comprising the joint allows the orthopaedist to recommend appropriate treatment.
Conclusions
The hip is a complex anatomic structure composed of osseous, ligamentous, and muscular structures responsible for transferring the weight of the body from the axial skeleton into the lower extremities. This must be accomplished while allowing for dynamic loading during activities such as gait and balance. Given this complex interplay between structures, the evaluation of hip pain can be technically difficult because of the multiples causes that may be responsible for similar symptoms of hip
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J.K.S. has received support from OrthoDynamix, Jacksonville, FL, exceeding $500 related to this research.