This 2010 narrative review synthesizes the biomechanics of the native hip and the consequences of common pathologies. It covers dysplasia, FAI, labral injury, capsular laxity, and articular cartilage damage alongside their surgical management. The goal is to give the treating surgeon a biomechanical framework for diagnosis and treatment decisions.
The reflex toward labral debridement was common before the biomechanical consequences of labral loss were quantified. A 92% rise in contact stress and lateral shift of the contact zone after labral removal provides the mechanistic case for repair-first arthroscopy.
When you see a dysplastic hip with a hypertrophied labrum, do not debride it in isolation. The hypertrophy is compensatory load-sharing; removing it without correcting coverage accelerates femoral head migration and arthritis.
When evaluating FAI, identify the type before planning surgery. Cam lesions need femoral neck osteoplasty; pincer lesions require acetabular rim trimming with labral re-fixation. Over-resecting the acetabular rim to treat pincer FAI can iatrogenically create dysplasia and shift the problem from impingement to instability.
The joint reactive force is dominated by abductor muscle force, not body weight alone — rehabilitation targeting gluteus medius strength is therefore biomechanically justified as a strategy to reduce hip loading after any hip procedure.
This 2010 narrative review synthesizes the biomechanics of the native hip and the consequences of common pathologies. It covers dysplasia, FAI, labral injury, capsular laxity, and articular cartilage damage alongside their surgical management. The goal is to give the treating surgeon a biomechanical framework for diagnosis and treatment decisions.
The reflex toward labral debridement was common before the biomechanical consequences of labral loss were quantified. A 92% rise in contact stress and lateral shift of the contact zone after labral removal provides the mechanistic case for repair-first arthroscopy.
When you see a dysplastic hip with a hypertrophied labrum, do not debride it in isolation. The hypertrophy is compensatory load-sharing; removing it without correcting coverage accelerates femoral head migration and arthritis.
When evaluating FAI, identify the type before planning surgery. Cam lesions need femoral neck osteoplasty; pincer lesions require acetabular rim trimming with labral re-fixation. Over-resecting the acetabular rim to treat pincer FAI can iatrogenically create dysplasia and shift the problem from impingement to instability.
The joint reactive force is dominated by abductor muscle force, not body weight alone — rehabilitation targeting gluteus medius strength is therefore biomechanically justified as a strategy to reduce hip loading after any hip procedure.