The Function of the Hip Capsular Ligaments: A Quantitative Report

Dynamic femoral head translations in dysplastic hips

“…Stepping-in-place lacks T. Sato et al Clinical Biomechanics 46 (2017) 40-45 the dynamics and hip range of motion of overground gait, so we can reasonably expect greater hip translations during true walking. This may be especially important in terminal stance with the hip extended, where the pubofemoral ligament and iliofemoral ligament inhibit external rotation (Martin et al, 2008). If DDH hips develop ligament laxity or dysfunction, greater anterior femoral translation may be observed.…”

Clinical and Instrumented Measurements of Hip Laxity and Their Associations With Knee Laxity and General Joint Laxity

“…We were somewhat surprised to obtain higher laxity values in 08 than in 308 of hip flexion (due primarily to greater hip external-rotation motion), given prior cadaveric work demonstrating greater hip internalexternal-rotation motion and less change in motion with ligament dissection at 308 versus 08. 27 However, direct comparisons between our in vivo values with this study may not be valid, as the authors of the cadaveric study did not report a standardized load limit at which motion was measured for each condition and removed all musculature to isolate the ligamentous support. As previously noted, in vivo laxity testing represents the combined passive resistance of the ligaments, muscles, and capsule to a displacing load.…”

“…We chose these test positions to account for the varying contributions of the hip capsular ligaments (ie, ischiofemoral ligament controlling internal rotation in flexion and extension, lateral iliofemoral ligament controlling internal and external rotation in flexion, and pubofemoral ligament with contributions from the medial and lateral iliofemoral ligaments controlling external rotation in extension). 27 With the participant lying prone, the pelvis restrained to keep the torso parallel to the floor, and the left knee flexed to 908 and secured in the knee cradle, we positioned the hip in 08 of flexion, rotation, and abduction-adduction, consistent with HIER ROM positioning. The nontest leg rested comfortably on a support.…”

An Algorithmic Approach to Mechanical Hip Pain

“…Femoral anteversion (normally between 8°and 15°) or retroversion is measured by the angle between the tibia and an imaginary vertical line [93]. If there is a significant difference in IR in the extended and seated flexed position, the examiner should differentiate between osseous and ligamentous causes [66]. The Ely and Phelps tests are helpful in diagnosing contractures of the rectus femoris and gracilis muscle, respectively, and both are performed with the patient in the prone position [90].…”