The posterior hip capsule receives contributions from all three hip ligaments but is primarily reinforced by the posterior fibres of the iliofemoral ligament and the ischiofemoral ligament. Posterior capsular laxity from repetitive hip internal rotation loading in dancers and athletes produces the posterior hip microinstability that paradoxically causes anterior impingement pain (from the femoral head migrating anteriorly into the anterior impingement zone as the loose posterior capsule fails to contain it).
| Origin | Posterior ilium and posterior acetabular rim |
|---|---|
| Insertion | Posterior intertrochanteric crest of the femur |
| Actions | Resists hip internal rotation; the posterior capsular component tightened in hip internal rotation and flexion |
|---|
Posterior hip capsular plication (tightening) during hip arthroscopy corrects the posterior microinstability that causes anterior impingement in hypermobile patients. The technique involves suture plication of the posterior capsule to reduce posterior joint volume and restore normal femoral head centreing.
Posterior capsular laxity in hypermobile athletes causing anterior impingement pattern from femoral head anterior shift managed with arthroscopic posterior capsular plication.
