THE HIP-JOINT. 363 



to the edge of the obturator foramen. Its lower circumference surrounds the neck 

 of the femur, being attached, in front, to the spiral or anterior intertrochanteric 

 line ; above, to the base of the neck ; behind, to the neck of the bone, about half 

 an inch above the posterior intertrochanteric line. From this insertion the fibres 

 are reflected upward over the neck of the femur, forming a sort of tubular sheath 

 (the cervical reflection], which blends with the periosteum and can be traced as far 

 as the articular cartilage. It is much thicker ait the upper and fore part of the 

 joint, where the greatest amount of resistance is required, than below and internally, 

 where it is thin, loose, and longer than in any other part. It consists of two sets 

 of fibres, circular and longitudinal. The circular fibres are most abundant at the 

 lawer and back part of the capsule, while the longitudinal fibres are greatest in 



FIG. 253. Left hip-joint laid open. 



amount at the upper and front part of the capsule, where they form distinct bands 

 or accessory ligaments, of which the most important is the ilio-femoral. The 

 other accessory bands are known as the pubo-femoral, passing from the ilio- 

 pectineal eminence to the front of the capsule ; ilio-trochanteric, from the anterior 

 inferior spine of the ilium to the front of the great trochanter ; and ischio-capsular, 

 passing from the ischium. just below the acetabulum, to blend with the circular 

 fibres at the lower part of the joint. The external surface (Fig. 239, page 337) is 

 rough, covered by numerous muscles, and separated in front from the Psoas and 

 Iliacus by a synovial bursa, which not unfrequently communicates, by a circular 

 aperture, with the cavity of the joint. It differs from the capsular ligament of the 

 shoulder in being much less loose and lax, and in not being perforated for the 

 pa-sage of a tendon. 



The Ilio-femoral Ligament (Figs. 239 and 254) is an accessory band of fibres 

 extending obliquely across the front of the joint; it is intimately connected with 

 the capsular ligament, and serves to strengthen it in this situation. It is attached, 

 above, to the lower part of the anterior inferior spine of the ilium ; and, diverging 

 below, forms two bands, of which one passes downward to be inserted into the 



