Hip Joint Complex PDF

Hip joint complex 1. Anatomic considerations - Proximal joint of the lower limb - Role: balance - Ball-and-socket joint — femoral head (convex) and acetabulum (concave) - 3 degrees of freedom - Second most mobile joint - Only one we cannot decoa...

Hip joint complex 1. Anatomic considerations - Proximal joint of the lower limb - Role: balance - Ball-and-socket joint — femoral head (convex) and acetabulum (concave) - 3 degrees of freedom - Second most mobile joint - Only one we cannot decoapt with the human strength - Function position: 10º - 20º 2. Range of motion - FLEXION: - Active flexion with extended knee: 90º - Active flexion with flexed knee: 120º - Passive flexion with extended knee: 120º - Passive flexion with flexed knee: 140º - EXTENSION: - Active extension with extended knee: 20º - Active extension with flexed knee: 10º - Passive extension with extended knee: 20º - Passive extension with flexed knee: 30º - ABDUCTION: 45º - ADDUCTION: 10º - 15º - INTERNAL ROTATION: 30º - 40º - EXTERNAL ROTATION: 60º 3. Main hip muscles - PSOAS MAJOR: flexion and external rotation - TFL: flexion, abduction and external rotation - QUADRICEPS: flexion - ADDUCTOR: flexion, adduction and internal rotation - SARTORIUS: flexion, abduction and internal rotation - GLUTEUS MAJOR: extension and external rotation - GLUTEUS MEDIUS: abduction and external rotation - GLUTEUS MINOR: adduction and internal rotation - PYRAMIDAL: abduction and external rotation - HAMSTRINGS: extension  4. TESTS THOMAS TEST - Performance: patient in supine position, and we ask him to bring the opposite knee to his chest - Outcome: test is positive if the tested leg is lifted off - Significance: shortening or snapping of the psoas SQUAT AND LUNGE - Performance: patient standing and we ask him for doing a squat and after, doing a lunge - Outcome: the hip tends to go into internal or external rotation in an exaggerated way - Significance: neutral profile, anteversion or retroversion — muscle weakness GLUTEAL TEST - Performance: there are two possibilities - Gluteus major: patient in prone position with flexed knee (90º) and external rotation of the hip. We ask for a push to the ceiling against or resistance - Gluteus medius: patient in lateral position with flexed knee (90º). We ask for an abduction of the hip against our resistance - Outcome: test is positive if we detect weakness - Significance: muscle deficitç BACK SAVER SIT AND REACH TEST - Performance: patient is sitting with knees stretched, and we ask him to flex the contralateral knee and try not to touch the toes of the feet with the hand on the same side - Outcome: distance from fingers to toes - Significance: hamstrings shortening