Updated: 1/17/2020

Hip Biomechanics

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Questions
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Evidence
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https://upload.orthobullets.com/topic/9064/images/hip-mechanics.jpg
https://upload.orthobullets.com/topic/9064/images/Hip copy_moved.jpg
https://upload.orthobullets.com/topic/9064/images/trendelenburg.jpg
Joint Biomechanics Definitions
  • Joint reaction force defined as force generated within a joint in response to forces acting on the joint
    • in the hip, it is the result of the need to balance the moment arms of the body weight and abductor tension 
    • maintains a level pelvis
  • Coupled forces
    • when two movements and associated forces are coupled
  • Joint congruence
    • relates to fit of two articular surfaces
    • high congruence increases joint contact area
  • Instant center of rotation
    • point about which a joint rotates
    • often changes during rotation due to joint translation
    • center of gravity of human is just anterior to S2
  • Friction and lubrication
    • not a function of contact area
    • lubrication decreases friction
    • examples
      • coefficient of friction of human joints is .002 to .04
      • TJA (metal on PE) is .05 to .15
Free Body Analysis Definitions
  •  Newtons laws
    • first law
      • if there is no net force on an object, its velocity remains constant
    • second law
      • force equals mass multiplied by acceleration
      • F=ma
    • third law
      • when a first body exerts a force on a second body, the second body exerts a force that is equal in magnitude and opposite in direction on the first body
      • F2=-F1
  • Force
    • definition
      • a push or pull on an object resulting from the object's interaction with another object
    • equation
      • force = mass x acceleration, F=ma
      • 1 Newton = force required to give 1 kg mass an acceleration of 1 m/s2 
  • Vector
    • definition
      • a quantity that contains both direction and magnitude
      • scalar quantities do not have direction 
    • forces and velocity can be broken down into vectors
  • Moment (torque)
    • definition
      • the tendency of a force to rotate a body around an axis
    • equation
      • moment (torque) = force(perpendicular) X distance
  • Work
    • definition
      • when a force acts upon an object to create displacement
    • equation
      • work = force (vector parallel to displacement) x distance
  • Energy
    • definition
      • ability of an object to perform work
    • classification
      • potential energy
        • equation
          • U (potential energy) = mass x gravity x height
      • kinetic energy
        • equation
          • KE (kinetic energy) = 1/2mv2
Hip Free Body Analysis
  • Free body analysis diagram
    • W = gravitational force
      • weight of the body minus weight of ipsilateral extremity (or 5/6 body weight)
    • M = abductor muscle force
    • R = joint reaction force
      • can reach 3 to 6 times body weight
  • Solving for joint reaction force (R)
    • step 1:  calculate My
      • principle
        • sum of all moments equals 0 
        • in this case, the moments are created by My and W
      • equation
      •  (A x My) + (B x W) = 0
        • assume A = 5cm and B = 12.5cm (this information will be given to you)
        • My = 2.5W
    • step 2:  calculate Ry
      • Ry = My + W
      • Ry = 2.5W + W
      • Ry = 3.5W
    • step 3:  calculate R
      • R = Ry / (cos 30°)
        • R = 3.5W / (cos 30°)
        • R = ~4W
Clinical Implications
  • Actions that decrease joint reaction force include 
    • increase in ratio of A/B (shift center of rotation medially)
      • acetabular side
        • moving acetabular component medial, inferior, and anterior 
      • femoral side
        • increasing offset of femoral component 
        • long stem prosthesis
        • lateralization of greater trochanter
          • by using increased offset neck/prosthesis
        • varus neck-shaft angulation
          • increases shear across joint
      • patient's gait
        • shifting body weight over affected hip  
          • this results in Trendelenburg gait 
        • cane in contralateral hand 
          • reduces abductor muscle pull and decreases the moment arm between the center of gravity and the femoral head 
        • carrying load in ipsilateral hand 
          • produces additional downward moment on same side of rotational point
  • Actions that increase joint reaction force include
    • valgus neck-shaft angulation
      • decreases shear across joint
 

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Questions (5)

(OBQ11.221) A cane held in the contralateral hand reduces joint reactive forces through the affected hip approximately 50% by which of the following mechanisms? Review Topic | Tested Concept

QID: 3644
1

Reducing hip abductor muscle pull

73%

(3169/4346)

2

Increasing hip flexor muscle pull

1%

(40/4346)

3

Moving the center of rotation for the femoroacetabular joint

21%

(902/4346)

4

Increasing joint congruence at the femoroacetabular joint

1%

(47/4346)

5

Moving the center of gravity posterior to the second sacral vertebra

4%

(153/4346)

L 3 C

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(OBQ09.172) Figure A represents a free body diagram of the hip of a patient standing on the right leg. The forces and distances are labeled on the diagram and the resulting hip joint force (J) = 1800N. What is the resultant value for J when the acetabular component is medialized given the new distances shown in Figure B? Review Topic | Tested Concept

QID: 2985
FIGURES:
1

1000N

5%

(153/2834)

2

1200N

64%

(1804/2834)

3

1800N

8%

(216/2834)

4

2200N

10%

(285/2834)

5

3600N

11%

(324/2834)

L 3 C

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(OBQ05.76) Patients display a Trendelenburg gait to compensate for weakness in which of the following muscle groups? Review Topic | Tested Concept

QID: 962
1

hip adductors

1%

(14/1394)

2

hip abductors

97%

(1351/1394)

3

hip flexors

1%

(8/1394)

4

knee extensors

0%

(2/1394)

5

hip extensors

1%

(7/1394)

L 1 D

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Evidences (8)
VIDEOS (1)
CASES (1)
Topic COMMENTS (31)
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