THE HIP- JOINT 421 



to the anterior inferior iliac spine, just below the origin of the 

 straight head of the rectus femoris. Distally it divides into two 

 parts, which are respectively attached to the upper and lower 

 portions of the intertrochanteric line. 



The medial, longer limb of the ilio-femoral ligament sustains 

 the forward pressure of the femoral head when the body is in 

 the erect attitude, and prevents hyperextension of the joint. 

 The shorter, lateral limb prevents too great a degree of adduction 

 and lateral rotation, as these movements render it tense. 



2. The Pubo-Capsular Ligament strengthens the infero- 

 medial part of the capsule. It becomes tense during the move- 

 ment of abduction. 



3. The Ischio-Capsular Ligament is a much weaker band, 

 which is placed in relation to the posterior aspect of the capsule. 

 It helps to prevent too great a degree of medial rotation. 



Although it is usually complete, the capsule is occasionally 

 interrupted by a communication between the joint cavity and 

 the bursa under the psoas major (p. 273). This opening lies 

 between the medial limb of the ilio-femoral and the pubo- 

 capsular ligament. 



The ligamentum teres is intra-capsular but extra-synovial. 

 It is attached distally to the head of the femur and proximally 

 to the transverse ligament and the edges of the acetabular 

 notch. It is completely surrounded by a tube of synovial 

 membrane (Fig. 125). 



The Synovial Membrane of the hip-joint covers the deep 

 surface of the capsule, and at the distal attachment of the 

 latter is reflected on to the femoral neck, where it is thrown 

 into numerous parallel ridges, known as the retinacula. At 

 the attachment of the capsule to the transverse ligament, the 

 synovial membrane forms a tube round the ligamentum teres 

 and also covers the pad of fat (Haversian gland) which occupies 

 the floor of the acetabulum (Fig. 125). 



Spread of Tuberculous Disease in the Region of 



the Hip-Joint. Tuberculous disease in the region of the hip- 

 joint commences most frequently in the neck of the femur, near 

 its lower surface, and close to the epiphyseal cartilage of the 

 head of the bone. It is in the first place extra-synovial but 

 intra-capsular, and, on this account, infection of the hip-joint 

 occurs with great frequency. As the disease progresses it 

 reaches the surface of the bone, destroys the periosteum, and 

 invades the synovial membrane. These changes are usually 



27 & 



