HSS Journal ®

, Volume 8, Issue 3, pp 192–197 | Cite as

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

  • Andrew D Speirs
  • Daniel L Benoit
  • Mélanie L Beaulieu
  • Mario Lamontagne
  • Paul E. Beaulé
Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip



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 


  1. 1.
    Lamontagne M, Brisson N, Kennedy MJ, Beaulé PE. Preoperative and postoperative lower-extremity joint and pelvic kinematics during maximal squatting of patients with cam femoro-acetabular impingement. J Bone Joint Surg Am. 2011;93 Suppl 2:40–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Arnold EM, Ward SR, Lieber RL, Delp SL. A model of the lower limb for analysis of human movement. Ann Biomed Eng. 2010;38:269–79.PubMedCrossRefGoogle Scholar
  3. 3.
    Heller MO, Bergmann G, Kassi J-P, et al. Determination of muscle loading at the hip joint for use in pre-clinical testing. J Biomech. 2005;38:1155–63.PubMedCrossRefGoogle Scholar
  4. 4.
    Bäthis H, Perlick L, Tingart M, et al. Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Jt Surg Br. 2004;86:682–7.CrossRefGoogle Scholar
  5. 5.
    Bergmann G, Deuretzbacher G, Heller M, et al. Hip contact forces and gait patterns from routine activities. J Biomech. 2001;34:859–71.PubMedCrossRefGoogle Scholar
  6. 6.
    Kleemann RU, Heller MO, Stoeckle U, Taylor WR, Duda GN. THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses. J Orthop Res. 2003;21:767–74.PubMedCrossRefGoogle Scholar
  7. 7.
    Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Rel Res. 2008;466:264–72.CrossRefGoogle Scholar
  8. 8.
    Kang MJ, Sadri H, Stern R, et al. Determining the location of hip joint centre: application of a conchoid’s shape to the acetabular cartilage surface of magnetic resonance images. Comp Meth Biomech Biomed Eng. 2011;14:65–71.Google Scholar
  9. 9.
    Davis RB, Õunpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci. 1991;10:575–87.CrossRefGoogle Scholar
  10. 10.
    Cereatti A, Margheritini F, Donati M, Cappozzo A. Is the human acetabulofemoral joint spherical? J Bone Jt Surg Br. 2010;92:311–4.CrossRefGoogle Scholar
  11. 11.
    Hicks JL, Richards JG. Clinical applicability of using spherical fitting to find hip joint centers. Gait Post. 2005;22:138–45.CrossRefGoogle Scholar
  12. 12.
    Lopomo N, Sun L, Zaffagnini S, Giordano G, Safran MR. Evaluation of formal methods in hip joint center assessment: an in vitro analysis. Clin Biomech. 2010;25:206–12.CrossRefGoogle Scholar
  13. 13.
    Leardini A, Cappozzo A, Catani F, et al. Validation of a functional method for the estimation of hip joint centre location. J Biomech. 1999;32:99–103.PubMedCrossRefGoogle Scholar
  14. 14.
    Taylor WR, Ehrig RM, Duda GN, et al. On the influence of soft tissue coverage in the determination of bone kinematics using skin markers. J Orthop Res. 2005; 23:726–34.PubMedCrossRefGoogle Scholar
  15. 15.
    van Weeren PR, van den Bogert AJ, Barneveld A. A quantitative analysis of skin displacement in the trotting horse. Equine Vet J Suppl. 1990; 9:101–9.PubMedGoogle Scholar
  16. 16.
    Siston RA, Delp SL. Evaluation of a new algorithm to determine the hip joint center. J Biomech. 2006;39:125–30.PubMedCrossRefGoogle Scholar
  17. 17.
    Piazza SJ, Okita N, Cavanagh PR. Accuracy of the functional method of hip joint center location: effects of limited motion and varied implementation. J Biomech. 2001;34:967–73.PubMedCrossRefGoogle Scholar
  18. 18.
    Ehrig RM, Taylor WR, Duda GN, Heller MO. A survey of formal methods for determining the centre of rotation of ball joints. J Biomech. 2006;39:2798–809.PubMedCrossRefGoogle Scholar
  19. 19.
    Nötzli HP, Wyss TF, Stoecklin CH, et al. The contour of the femoral head–neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–60.PubMedCrossRefGoogle Scholar
  20. 20.
    Wu G, Siegler S, Allard P, et al. ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion—part I: ankle, hip, and spine. International Society of Biomechanics. J Biomech. 2002;35:543–8.Google Scholar
  21. 21.
    Stindel E, Gil D, Briard J-L, et al. Detection of the center of the hip joint in computer-assisted surgery: an evaluation study of the surgetics algorithm. Comp Aid Surg. 2005;10:133–9.Google Scholar
  22. 22.
    Cereatti A, Donati M, Camomilla V, Margheritini F, Cappozzo A. Hip joint centre location: an ex vivo study. J Biomech. 2009;42:818–23.PubMedCrossRefGoogle Scholar
  23. 23.
    Menschik F. The hip joint as a conchoid shape. J Biomech. 1997;30:971–3.PubMedCrossRefGoogle Scholar
  24. 24.
    Cappozzo A, Catani F, Leardini A, Benedetti MG, Croce UD. Position and orientation in space of bones during movement: experimental artefacts. Clin Biomech. 1996;11:90–100.CrossRefGoogle Scholar
  25. 25.
    Piazza SJ, Erdemir A, Okita N, Cavanagh PR. Assessment of the functional method of hip joint center location subject to reduced range of hip motion. Journal of Biomechanics. 2004;37:349–56.PubMedCrossRefGoogle Scholar
  26. 26.
    Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991;73:709–14.PubMedGoogle Scholar

Copyright information

© Hospital for Special Surgery 2012

Authors and Affiliations

  • Andrew D Speirs
    • 1
  • Daniel L Benoit
    • 2
  • Mélanie L Beaulieu
    • 3
  • Mario Lamontagne
    • 3
  • Paul E. Beaulé
    • 4
  1. 1.Orthopaedic Biomechanics LaboratoryCHEO Research Institute IOttawaCanada
  2. 2.School of Rehabilitation ScienceUniversity of OttawaOttawaCanada
  3. 3.Human Movement Biomechanics Laboratory, School of Human KineticsUniversity of OttawaOttawaCanada
  4. 4.Division of Orthopaedic Surgery, University of OttawaThe Ottawa HospitalOttawaCanada

Personalised recommendations