Hip Joint Anatomy and Motion Quiz

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Questions and Answers

What is the recommended activity for a patient with a cemented hip joint post-surgery during the first week?

Start ambulation without assistive devices

Initiate isometric exercises as tolerated (correct)

Progress to 2/3 weight bearing

Begin transitioning to full weight bearing

Which of the following is NOT advised for a patient after hip surgery?

Walking with a cane at week 4 (correct)

Twisting the legs while lying down

Crossing the legs while sitting

Sitting in a low chair less than 53 cm

For patients with a cemented-less hip joint, when can they expect to begin transitioning to full weight bearing?

At week 10

At week 6 (correct)

At week 8

At week 12

During the rehabilitation process, which movement is restricted for anterolateral and true lateral incision patients?

External rotation Signup and view all the answers

What is the weight bearing status for a cemented hip joint patient by approximately 3 weeks post-surgery?

Partial weight bearing for approximately 3 weeks Signup and view all the answers

What is the recommended initial weight bearing period for an un-cemented hip prosthesis?

6-12 weeks Signup and view all the answers

Which exercise should NOT be encouraged until quadriceps and iliopsoas control has fully returned?

Straight Leg Raises (SLR) Signup and view all the answers

What type of exercises are emphasized for transfer training after hip surgery?

Upper extremity exercises to assist in shifting weight Signup and view all the answers

When can driving be resumed after a total hip replacement?

6 weeks after surgery Signup and view all the answers

What is the primary purpose of using an abduction pillow during recovery?

To prevent dislocation of the hip joint Signup and view all the answers

Which activity is appropriate for strengthening the lower limb after total hip replacement?

Terminal knee extension Signup and view all the answers

What is the primary goal of performing respiratory exercises post-surgery?

To reduce risks of pneumonia or respiratory complications Signup and view all the answers

What type of cane should be introduced 3-4 weeks after surgery?

Single point cane Signup and view all the answers

During rehabilitation, when should hip internal rotation be avoided for patients with hip replacement?

For 3-6 weeks Signup and view all the answers

Which exercise is best for improving balance post-hip surgery?

Pool therapy Signup and view all the answers

What is the primary function of the hip joint in relation to the skeletal system?

Provide stability and transmit weight Signup and view all the answers

Which ligament is NOT associated with the stabilization of the hip joint?

Iliotibial band Signup and view all the answers

What position is considered the resting position of the hip joint?

30 degrees flexion, 30 degrees abduction, slight lateral rotation Signup and view all the answers

Which condition is NOT listed as a potential reason for a total hip arthroplasty?

Tendinitis of the hamstring Signup and view all the answers

What change in hip joint anatomy can increase the risk of arthritis?

Shallow or retroverted acetabular socket Signup and view all the answers

Which statement is true regarding the motion of the pelvis on the femur?

Anterior tilting produces hip flexion Signup and view all the answers

Which of the following symptoms is characteristic of hip arthritis?

Stiffness and pain with passive internal rotation Signup and view all the answers

In which position does the hip joint exhibit a close-packed position?

Extension, medial rotation, and abduction Signup and view all the answers

What is a major concern during the initial healing phase after hip arthroplasty?

Joint dislocation Signup and view all the answers

Which material has a significantly lower friction coefficient compared to natural joints?

Stainless steel Signup and view all the answers

Which surgical approach involves excising the greater trochanter?

True lateral approach Signup and view all the answers

What is a primary reason for recommending hip arthroplasty in patients over 60?

Age-related joint degeneration Signup and view all the answers

What is typical of an anteriorly dislocated hip?

Shortened, externally rotated, and in extension Signup and view all the answers

Which technique requires a period of non-weight bearing to ensure stabilization of the component?

Cementless technique Signup and view all the answers

What postoperative exercise focuses on strengthening the quadriceps?

Quadriceps sets Signup and view all the answers

Which complication is NOT commonly associated with hip arthroplasty?

Heart palpitations Signup and view all the answers

In which approach would the hip dislocate with excessive flexion and internal rotation?

Posterolateral approach Signup and view all the answers

What is the typical initial presentation of the affected leg in a posterior dislocation?

Internally rotated and adducted Signup and view all the answers

What is a characteristic of the bioingrowth technique?

Relies on natural bone growth around the implant Signup and view all the answers

Which of the following exercises is NOT recommended as part of the treatment for hip dysfunction?

High-impact jumping Signup and view all the answers

What is a common immediate complication following a hip dislocation?

Sciatic nerve injury Signup and view all the answers

Which treatment is recommended for posterior dislocation of the hip?

Manipulative reduction Signup and view all the answers

In which year was the first successful total joint replacement performed?

1959 Signup and view all the answers

What characterizes semi-constrained joint prosthesis?

Restricted movement, but some flexibility exists Signup and view all the answers

Which of the following statements is incorrect regarding the treatment of hip dislocations?

Immediate weight bearing is recommended for anterior dislocations Signup and view all the answers

What may lead to avascular necrosis following a hip injury?

Avulsion of ligamentum teres Signup and view all the answers

What is the main objective of using a cane in the opposite hand for hip dysfunction?

To unload the hip Signup and view all the answers

Which condition is characterized by the affected leg being externally rotated and abducted?

Anterior dislocation Signup and view all the answers

Study Notes

Hip Joint

The hip joint is the second largest in the body.
Connects the pelvic girdle to the lower extremity.
Provides stability and mobility.
Transmits weight between axial and appendicular skeletons.
Commonly affected by arthritis.

Anatomy

Diarthrodial, ball and socket joint.
Femoral head is two-thirds of a perfect sphere.
The entire head is covered by cartilage (except the fovea).
The femoral head typically faces medially, superiorly, and anteriorly.
The acetabulum is incomplete near the inferior pole (transverse acetabular ligament).

Ligaments

Iliofemoral ligament.
Pubofemoral ligament.
Ischiofemoral ligament.
Ligamentum teres.

Hip Joint Motion

Anterior and posterior tilting of the pelvis on the fixed femur produces hip flexion and extension, respectively.

Capsular Pattern

Resting position: 30 degrees of flexion, 30 degrees of abduction, slight lateral rotation.
Close-packed position: Extension, medial rotation, and abduction.
Capsular pattern: Flexion, abduction, medial rotation (order may vary).

Hip Disorders

Rheumatoid arthritis.
Ankylosing spondylitis.
Avascular necrosis.
Hemophilia.
Post fracture or dislocation.
Hereditary disorders.
Idiopathic.
Osteomyelitis.
Bone tumor.
Osteoarthritis.
Developmental dysplasia of the hip.
Hip impingement (femoroacetabular impingement).

Hip Arthritis

Arthritis of the hip can result from many causes.
About 30% of all patients have mild acetabular dysplasia and 30% have a retroverted socket.
These conditions reduce the contact area of the femoral head in the acetabulum, increasing pressure and wear.
Approximately 30% of patients have no obvious risk factors.
Characterized by:
- Loss of articular cartilage.
- Joint space narrowing and pain.
- Stiffness.
- Osteophyte formation (bone spurs).
Symptoms:
- Difficulty with daily living activities.
- Pain with passive internal rotation of the hip.
- Tenderness over the joint capsule.
- Restricted range of motion.
- Abductor limp.
- Functional leg-length discrepancy (abduction contracture).
Treatment:
- Cane in the opposite hand.
- Stretching and strengthening exercises.
- Yoga.
- Leg rotations.
- Leg raises.
- Knee cross-overs.
- Strengthening exercises using resistance bands.
- Straight leg lifts.
- Knee-to-chest lifts.
- Mini-squat exercises.

Hip Joint Dislocation

Types:
- Anterior dislocation
- Posterior dislocation (more common).
- Central dislocation (direct thrust along the line of the femoral neck).

Posterior Hip Dislocation

Caused by a longitudinal thrust along the femoral shaft when the hip is flexed and adducted.
The head of the femur is displaced backward out of the acetabulum.
Symptoms:
- Internally rotated leg.
- Adducted leg.
- Shortened leg.

Posterior Hip Dislocation Complications

Immediate:
- Sciatic nerve injury.
Late:
- Avascular necrosis of the femoral head.

Anterior Hip Dislocation

Caused by a force that abducts the extended hip.
The femoral head is displaced below and in front of the acetabulum.
Symptoms:
- Abducted leg.
- Externally rotated leg.

Hip Dislocation Treatment

Posterior dislocation:
- Manipulative reduction.
- Traction (4 weeks).
- Weight bearing.
- Regular X-rays.
Anterior dislocation:
- Manipulative reduction.
- 3 weeks of traction.

Hip Arthroplasty

Surgical construction of a new artificial, painless, movable, and stable hip joint.
The first successful joint replacement in humans was in 1959.
The hip was the first joint to be successfully replaced.
Types:
- Total arthroplasty (full joint replacement).
- Hemiarthroplasty (partial joint replacement).

Hip Arthroplasty Components

Constrained: restricted movement in all anatomical planes.
Semi-constrained: some movement is allowed in all planes.
Unconstrained: permits free movement in all anatomical planes (prone to dislocation until 6 weeks post-operation).

Hip Replacement Materials

Inert metals with low friction coefficients:
- Stainless steel.
- Chrome-cobalt-molybdenum alloys.
- High-density polyethylene.

Indications for Hip Replacement

Pain.
Loss of function.
Osteoarthritis.
Rheumatoid arthritis.
Post-traumatic joint stiffness.
Avascular necrosis.
Recommended age: 60 years or older.

Hip Replacement Fixation

Acrylic cement.
Bioingrowth (no cement used).

Hip Replacement Surgical Approaches

Anterolateral: between tensor fascia lata and glutei.
Posterolateral: through the posterior capsule.
True lateral: excision of the greater trochanter.

Hip Replacement Complications

Dislocation.
Wear.
Venous thrombi.
Fractures.
Postoperative thigh pain.
Failure.
Infection.

Hip Replacement Postoperative Care

Transfer techniques.
Assistive devices.
Exercises:
- Ankle pumps.
- Quadriceps sets.
- Gluteal sets.
- Active hip and knee flexion.
- Isometric hip abduction.
- Active hip abduction.

Hip Replacement Rehabilitation

Restoration of:
- Joint motion.
- Muscle strength.
Maintenance of:
- Vascular function.
- Respiratory function.
Education about:
- Joint preservation techniques.
- Bed mobility.
- Weight bearing.

Postoperative Weight Bearing

Cemented: partial weight bearing (PWB) for 3 weeks.
Cementless: touch-down weight bearing (TDWB) to weight bearing as tolerated (WBAT).

Hip Replacement Precautions

Avoid:
- Excessive extension, external rotation, and adduction (anterolateral & true lateral incision).
- Excessive flexion, internal rotation, and adduction (posterolateral incision).
- Sitting in low chairs.
- Bending forward for shoes, socks, cutting toenails.
- Crossing legs.
- Twisting legs.
- Driving.
- Jumping.
- Running.
- Contact sports.

Hip Replacement Activities

Low-impact:
- Sailing.
- Swimming.
- Cycling.
- Golfing.
- Bowling.
High-impact:
- Running.
- Water-skiing.

Cemented vs Cementless Hip Replacements

Internal rotation of the hip joint:
- Don’t perform for 3-6 months.
Adduction of the hip joint:
- Don’t perform for 3-6 months.
Flexion of the hip joint beyond 90 degrees:
- Don’t perform for 3-6 months.
Isometric exercise:
- Immediately postoperative as tolerated.
Active exercise:
- Initiation is variable between weeks 1 through 4.
Ambulation:
- Cemented:
  - Partial weight bearing for 3 weeks.
  - Begin ambulation with cane at week 4.
  - Begin full weight bearing at week 5.
- Cemented-less:
  - Touch-down weight bearing for 3 weeks.
  - Progress to 1/3 weight bearing at week 6.
  - Progress to 2/3 weight bearing at week 8.
  - Progress to full weight bearing at week 10.

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Description

Test your knowledge about the hip joint, its anatomy, and motion mechanics. This quiz covers the essential ligaments, capsular patterns, and the role of the hip joint in stability and mobility. Perfect for students of anatomy or anyone interested in human biomechanics.