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Hip Joint Restoration pp 57–73Cite as

Functional Mechanics of the Human Hip

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Abstract

The application of scientific principles to the study of the hip has provided insight into morphologic and biomechanical factors compromising hip function, including acquired abnormalities (e.g., posttraumatic deformities, Perthes disease, slipped capital femoral epiphysis), developmental pathologies (e.g., developmental dysplasia of the hip [DDH]), and abnormalities of unknown origin (e.g., cam deformity of the femoral head-neck junction and pincer deformities of the acetabular margin).

However, the response of biologic tissues to repetitive overload is a function of both bony morphology and external loading and thus the nature and frequency of patients’ activities. Thus the stresses developed within the tissues are a function of the external forces acting on the body, the muscle forces required to generate joint motion, and the area of contact between the articulating surfaces of the femur and the acetabulum. These basic principles may provide insight into the pathomechanics of common hip conditions.

For example, developmental dysplasia is characterized by reduced coverage of the femoral head by a shallow, inclined acetabulum. The reduced area of the weight-bearing surface leads to high contact stresses and overloading of the labrum and hip capsule, leading to joint degeneration. On the other hand, femoroacetabular impingement is seen in hips with normal (cam) or excessive (pincer) coverage. In these joints, pathologic changes occur when joint motion is driven beyond the limit imposed by impingement between the femur and the acetabular margin, often with degeneration of the labro-chondral junction leading to delamination of the articular surface. And at the opposite extreme, the unstable hip is typically encountered in patients with hyperlaxity leading to excessive joint motion due to loss of the normal capsular restraints that work in concert with the bony structures of the joint to prevent subluxation.

In this chapter we present a biomechanical perspective to each of these pathologic conditions after first discussing the essentials of the joint forces, motions, and tissues that form the basis of normal hip function.

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Authors and Affiliations

  1. Institute of Orthopedic Research and Education, 6550 Fannin Street, Suite 2501, Houston, TX, 77030, USA

    Philip C. Noble PhD (Director of Research)

  2. Institute of Orthopedic Research and Education, Houston, TX, 77030, USA

    Philip C. Noble PhD (Director of Research)

  3. Department of Orthopedics, Kaplan Joint Center, Newton Wellesley Hospital, 2014 Washington Street, Suite 361, Newton, MA, 02462, USA

    Maureen K. Dwyer PhD, ATC

  4. Department of Orthopedics, Massachusetts General Hospital, Boston, MA, USA

    Maureen K. Dwyer PhD, ATC

  5. Department of Orthopedics and Traumatology, Cairo University, Cairo, Egypt

    Mohammed S. Gobba MD

  6. Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6550 Fannin Street, Suite 2500, Houston, TX, 77030, USA

    Joshua D. Harris MD

  7. Weill Cornell Medical College, Houston, TX, USA

    Joshua D. Harris MD

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  1. Philip C. Noble PhD
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  2. Maureen K. Dwyer PhD, ATC
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  3. Mohammed S. Gobba MD
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  4. Joshua D. Harris MD
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Corresponding author

Correspondence to Philip C. Noble PhD .

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Editors and Affiliations

  1. Orthopedic Surgery, Hip Joint Arthroplasty, Hip Arthroscopy Massachusetts General Hospital, Boston, Massachusetts, USA

    Joseph C. McCarthy

  2. Institute of Orthopedic Research and Education, Houston, Texas, USA

    Philip C. Noble

  3. Consultant Orthopedic Surgeon Orthopedics, The Villar Bajwa Practice, Spire Cambridge Lea Hospital, Cambridge, United Kingdom

    Richard N. Villar

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Noble, P.C., Dwyer, M.K., Gobba, M.S., Harris, J.D. (2017). Functional Mechanics of the Human Hip. In: McCarthy, J., Noble, P., Villar, R. (eds) Hip Joint Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0694-5_7

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  • DOI: https://doi.org/10.1007/978-1-4614-0694-5_7

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