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Forces acting on the Hip Joint

- Discussion:
    - broad range of forces acts upon the hip joint;
    - muscles that cross hip joint generate most of the load that it bears;
    - femoral neck fracture:
           - distance between the head and shaft of the femur determines the moment arm tending to produce varus;
           - shorter moment arm, & thus less deforming force, follows valgus reduction;
    - gait:
           - standing:
                  - wt of body equally distributed to lower limbs, so that weight on each femoral head is half of the body weight above hips;
                  - in one-legged stance, as in walking, head of femur serves as fulcrum;
                         - the standing hip must support the wt of the patient's head, upper extremities, torso, as well as the contralateral, non supporting, limb;
                  - in order to maintain the pelvis level to the ground, the gluteus medius & minimus must pull pelvis downward lateral to the fulcrum.
                         - upward opposing force is that of fulcrum, head of femur, force that is sum of the two downward forces;
                  - cane obviates decrease need for hip abductors on affected side to contract;
                  - may relieve upto 60% of the load on hip in stances phase;
                  - unsupported gait may result in 4 to 7 times body wt across hip where as supported gait (w/ a walker or a cane) may produce loads across the hip of 2-3 times body wt;
    - supine:
           - joint reaction forces during supine straight leg raising > 3 times body wt;
           - getting on & off bed pan is equal to four times body wt



Hip joint loading during walking and running, measured in two patients.

Telemeterized in vivo hip joint force data: a report on two patients after total hip surgery.

Telemetric Force Measurements across the Hip after Total Arthroplasty.

Medial-displacement intertrochanteric osteotomy in the treatment of osteoarthritis of the hip. A long-term follow-up study.

Hip Motion Measurements for Selected Activities of Daily Living.

The Effect of Cane Use on Hip Contact Force.

Mechanics of the normal and osteoarthritic hip. A new perspective.

The role of femoral neck anteversion in the development of osteoarthritis in dysplastic hips