The anterior hip capsule is a thick fibrous sleeve reinforced by the iliofemoral ligament (anteriorly and superiorly) and the pubofemoral ligament (anteroinferiorly). It is the strongest capsular region of the hip joint.
| Origin | Anterior acetabular rim and labrum, including the anterior inferior iliac spine region |
|---|---|
| Insertion | Intertrochanteric line of the femur |
Provides the primary anterior constraint of the femoral head in the acetabulum, resists hyperextension of the hip, and is the most robust component of the hip capsular complex due to the iliofemoral ligament reinforcement.
The anterior hip capsule is the primary site of hip flexion contracture from capsular fibrosis (Thomas test positive) after hip infection, arthritis, or prolonged immobilisation. Anterior capsulotomy provides access in the anterior approach to total hip arthroplasty, and capsular repair afterwards reduces dislocation risk. In hip arthroscopy for femoroacetabular impingement, an over-aggressive capsulotomy left unrepaired can cause anterior instability, so capsular closure is commonly performed.
Anterior capsular fibrosis producing hip flexion contracture measured by Thomas test, managed by stretching and anterior capsular release in refractory cases.
Reattachment of the anterior hip capsule after total hip arthroplasty to reduce anterior dislocation risk, particularly in the direct anterior approach.
Anterior subluxation after excessive capsulotomy during hip arthroscopy, treated with capsular plication or repair.
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