The posterior hip capsule is thinner than the anterior capsule and is reinforced mainly by the ischiofemoral ligament, with the circular fibres of the zona orbicularis around the femoral neck. It contains the femoral head posteriorly and tightens in flexion, adduction and internal rotation. Laxity of the capsule in hypermobile athletes and dancers may contribute to hip microinstability.
| Origin | Posterior acetabular rim and posterior labrum |
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| Insertion | Posterior femoral neck (intertrochanteric region) |
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Contains the femoral head posteriorly and limits hip internal rotation and flexion-adduction.
The posterior capsule is torn in posterior hip dislocation, the most common traumatic hip dislocation, typically from a dashboard injury with the hip flexed and adducted; urgent reduction reduces the risk of femoral head avascular necrosis. After posterior approach total hip arthroplasty, repair of the posterior capsule and short external rotators significantly reduces dislocation rates. In hypermobile patients, capsular laxity with poor muscular control is thought to allow abnormal femoral head translation and pain, and capsular plication during hip arthroscopy may be used.
Capsular laxity in hypermobile athletes allowing abnormal femoral head translation and hip pain, managed with rehabilitation and capsular plication during hip arthroscopy when needed.
Traumatic dislocation tearing the posterior capsule and ischiofemoral ligament, requiring urgent reduction to lower the risk of femoral head avascular necrosis.
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