Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

HSS Journal ®

, Volume 8, Issue 3, pp 192-197

First online:

The Accuracy of the Use of Functional Hip Motions on Localization of the Center of the Hip

  • Andrew D SpeirsAffiliated withOrthopaedic Biomechanics Laboratory, CHEO Research Institute I
  • , Daniel L BenoitAffiliated withSchool of Rehabilitation Science, University of Ottawa
  • , Mélanie L BeaulieuAffiliated withHuman Movement Biomechanics Laboratory, School of Human Kinetics, University of Ottawa
  • , Mario LamontagneAffiliated withHuman Movement Biomechanics Laboratory, School of Human Kinetics, University of Ottawa
  • , Paul E. BeauléAffiliated withDivision of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access



The hip joint is generally considered a ball-and-socket joint, the center of which is used as an anatomic landmark in functional analyses and by surgical navigation systems. The location of the hip center has been estimated using functional techniques using various limb motions. However, it is not clear which specific motions best predicted the functional center.


This study aims to compare the predicted functional center of the hip evaluated from multiplanar circumduction and star motions, and to compare this functional center with the geometric center.


Eight hips in four fresh–frozen cadavers were used and verified as morphologically normal in CT scans. Three-dimensional motion of each lower limb was recorded using arrays of reflective markers rigidly attached to the femur and pelvis. Each hip was manipulated to produce circumduction or star motion, i.e., abduction–adduction and flexion extension. The hip was then dissected and the bearing surface traced with a probe, from which a best-fit sphere was calculated. The functional center was calculated from the motion data and compared to the geometric technique.


There was no difference between the functional hip center predicted by circumduction or star motions, although this was offset from the geometric hip center by up to 14 mm. For all except two hips, the functional center was less than 6 mm from the geometric hip in each anatomic direction. Test–retest differences were smaller for circumduction than for star motions.


Estimation of the hip center based on motion of the femur relative to the pelvis could localize the geometric center of the joint within 14 mm and circumduction motions were more repeatable.

Clinical Relevance

Many surgical navigation systems make use of the functional hip center as a landmark for alignment or reconstruction. Errors associated with this would have a very minor influence in lower limb alignment, e.g., for knee reconstruction, but could affect proximal femoral geometry relevant to hip reconstruction.


hip center functional center estimation accuracy surgical navigation