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Hip and Knee


Bony strcutures of the hip pelvis (ilium, ischium, pubic bone) femur
where do the hip ligaments attatch along the rim of the acetabulum to femoral neck
functions of the hip ligaments limit hyperextension, allow flexion, enable standing upright without use of muscles
Another name for the y ligament ligament of bigelow
function of the y ligament reinforce capsule anteriorly
function of the pubofemoral ligament limits hyperextension and abduction
function of the ischiofemoral ligament limits hyperextension and internal rotation
hip joint arthrokinematics femur: convex femoral head slides opposite (6 motions) pelvis: linked in closed
what controls or limits the amount of lateral pelvic tilting opposite muscle groups work as a forced couple
What happens as a result of decreased flexibility in the hip region weight bearing forces will be transmitted through the spine rather than absorbed by the pelvis
Weak hip abductors (pirformis, sartorius, glute med, TFL) can result in patellofemoral impairment with valgus stress
Piriformis syndrome results in weak hip extensors and abductors
Anterior pelvic tilt posture can result in short TFL and IT band; limited external rotation; weak piriformis and glute med; excessive internal rotation of the femur during the first half of stance phase with increased stress on the medial knee structures;
Coxa valga pathologically large angle of inclination of the neck and shaft of the femur; longer leg
Coxa vara pathologically smaller angle; shorter leg
anteversion increased torsion of the femoral neck, shaft rotated medially; genu valgum, pes planus, shorter leg
retroversion decreased torsion of the femoral neck, shaft rotated laterlaly; genu varum, pes cavus, longer leg
what type of posture and gait can result from excessive anteversion toe in
retroversion, if uncompensated can cause what? excessive exposure of the femoral head posteriorly
what do the hip flexors control during gait hip extension at end of stance, then become concentric to initiate swing
what do the hip extensors control during gait flexor movement during loading response; glut max initiates hip extension
what do the hip abductors control during gait? lateral pelvic tilt during swinging of opposite leg
what are some major nerves subject to injury or entrapment in the hip? sciatic, obturator, and femoral
What are the nerve roots associated with referred pain in the buttock and hip region? L1-L3; S1-S2
what are some common structural and functional impairments of hypomobility of the hip joint groin pain, stiff after rest, decreased ROM, firm end feels, LBP due to pathomechanics, knee flexion contracture, impaired balance, impaired posture,
Hip joint hypomobility protection phase patient education, decrease pain at rest, decrease pain during weight bearing activities, decrease stiffness and maintain available motion
Hip joint hypomobility controlled motion and return to function phase progressively increase joint play and soft tissue mobility; improve joint tracking and pain free motion; improve muscle performance in supporting muscles, balance, and aerobic activity; patient education
What are the indications for a THA OA; severe pain; limited weight bearing or ROM; Tumor; fracture
True or False: Immobilization is encouraged after a THA False
THA max protection phase prevent dislocation or subluxation; prevent relfex inhibiton and atrophy; prevent flexion contracture; promote functional level of strength and endurance in non operative lower extremity
THA mod protection phase promote strength and muscle endurance in hip abductors and extensors; cardiovascular endurance; ROM within precautions; postural stability, balance and gait.
Created by: bsa8581