The ischiofemoral ligament reinforces the posterior hip capsule, running spirally from the ischium around the posterior femoral neck to the greater trochanter. It becomes taut during hip internal rotation and extension, limiting both movements and providing posterior joint stability. It is the weakest of the three hip capsular ligaments and the one least often injured in isolation.
| Origin | Ischial portion of the acetabular rim and labrum |
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| Insertion | Greater trochanter medial surface and femoral neck |
| Actions | Limits internal rotation of the hip; reinforces the posterior hip capsule |
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The ischiofemoral ligament is an important consideration in total hip arthroplasty via the posterior approach, where its preservation alongside the posterior capsule significantly reduces the risk of posterior dislocation. Ischiofemoral impingement syndrome involves the quadratus femoris being compressed between the ischium and femoral neck, rather than the ligament itself, but the two structures are in close anatomical proximity.
Disruption of the ischiofemoral ligament during posterior hip dislocation or in athletes with posterior hip instability, producing posterior hip pain and instability confirmed on MRI.
