Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Passive medial rotation

Positioning.

The subject lies in the supine position with the hip and knee bent to 90°. The
examiner stands level with the subject’s hip. One hand supports the lower leg just above the ankle, the other hand stabilizes the femur at the knee.

Procedure.

Rotate the lower leg outwards, meanwhile assuring the vertical position of the femur,until the movement comes to a soft stop.Observe the anterior iliac spine of the opposite side to detect the start of a lateral pelvic tilt.

Common mistakes.

The movement is continued beyond the possible range, which causes a lateral
tilt of the pelviS.

Normal functional anatomy:

• Rallge: 45-60°
• Elld1eel: ligamentous
• Limitillg strllctures:

– the ischiofemoral ligament
– buttock muscles:

gluteus maximus, gluteus medius, piriformiS, gemelli, obturator
extemus and intemus, quadratus femoris.

Common pathological situations:

• In arthritis, the medial rotation is the most painful movement.
• In arthrosis it is usually the first movement to become limited.

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