The iliofemoral ligament (Y-ligament of Bigelow) is the strongest ligament in the body, running from the anterior inferior iliac spine to the intertrochanteric line as an inverted Y.
Primary restraint against hip extension and external rotation, prevents anterior hip dislocation, allows passive erect posture without muscular effort.
Contracture produces hip flexion deformity (Thomas test positive). Preserved in anterior THA for stability. Release required for high-grade spondylolisthesis hip flexion contracture correction.
Iliofemoral ligament contracture producing fixed hip flexion measured by Thomas test, requiring anterior capsular release.
Preservation of the iliofemoral Y-ligament during direct anterior hip arthroplasty maintaining anterior hip stability.
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