Skip to main content

Catalog. Arthroscopic reconstruction

 

Introduction 

Currently, ligamentum capitis femoris (LCF) reconstruction using arthroscopic technologies is considered promising. According to the literature available to us, the first such operation was performed by Marc J. Philippon, which he first reported on in May 2006 (2006PhilipponMJ). Until now, reconstruction of LCF using minimally invasive technologies has not yet become widespread. The long-term results of arthroscopic LCF repair are still uncertain due to insufficient number of surgical procedures performed and short follow-up period (2014O'DonnellJM_SinghPJ).

Catalog

Arthroscopic LCF reconstruction and discussion of technique

Abibe RB, Rahal SC, dos Reis Mesquita L, Doiche D, da Silva, JP, Mamprim, MJ, Pinho RH, Battazza A, Alves CEF, Saunders WB. Ligamentum teres reconstruction using autogenous semitendinosus tendon with toggle technique in rabbits. PeerJ. 2023;11:e14777. doi.org/10.7717/peerj.14777 [peerj.compeerj.com(PDF)]

Al'Khafaji, I., Olszewski, Y., Clarnette, G., Settle, E., Ernstbrunner, L., O'Donnell, J., & Ackland, D. (2024). The contribution of the ligamentum teres to the hip fluid seal: A biomechanics study. Clinical Biomechanics, 106186. [pubmed.ncbi.nlm.nih.gov sciencedirect.com]

Amenabar T, O’Donnell J. Arthroscopic ligamentum teres reconstruction using semitendinosus tendon: Surgical technique and an unusual outcome. Arthrosc Tech. 2012;1(2)e169-74. doi.org/10.1016/j.eats.2012.07.002 [sciencedirect.com]

Ankem HK, Diulus SC, Meghpara MB, Rosinsky PJ, Shapira J, Maldonado DR, ... Domb BG. Arthroscopic triple reconstruction in the hip joint: restoration of soft-tissue stabilizers in revision surgery for gross instability. Arthroscopy Techniques. 202110(5)e1239-48. [sciencedirect.com]

Arkhipov SV. Underwater Rock of the Ligamentum Teres Reconstructions. Ligamentum Teres – Ligamentum Incognitum. 2019, December 23:1-3. doi.org/10.13140/RG.2.2.22632.42249 [researchgate.net]

Bajwa AS, Cantab MP, VillarRN. Editorial Commentary: Arthroscopic Hip Ligamentum Teres Reconstruction – Reality or Mythology? 2018;34(1)152-4. doi.org/10.1016/j.arthro.2017.11.003 [sciencedirect.com]

Bajwa A. What the papers say. Journal of Hip Preservation Surgery. 2023;8(4)384-6. [ncbi.nlm.nih.gov]

Bourgeault-Gagnon Y, Cohen D, Ayeni OR. Editorial Commentary: Borderline Hip Dysplasia Combined With Increased Anteversion and Ligamentum Teres Disruption Is a Recipe for Hip Microinstability. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2024;11. [arthroscopyjournal.org sciencedirect.com]

Brady AW, Chahla J, Locks R, Mikula JD, SletteEL, LaPrade RF, Philippon MJ. Arthroscopic reconstruction of the ligamentum teres: A guide to safe tunnel placement. Arthroscopy. 2018;34(1)144-51. doi.org/10.1016/j.arthro.2017.08.308 [sciencedirect.com]

Briggs KK, Pennock A, Philippon MJ. Paper 36: Arthroscopic Ligamentum Teres Reconstruction. Arthroscopy. 2011;27(1)e20-1. doi.org/10.1016/j.arthro.2010.11.049 [arthroscopyjournal.org]

Chaharbakhshi EO, Perets I, Ashberg L, Mu B, Lenkeit C, Domb BG. Do ligamentum teres tears portend inferior outcomes in patients with borderline dysplasia undergoing hip arthroscopic surgery? A match-controlled study with a minimum 2-year follow-up. The American journal of sports medicine. 2017;45(11)2507-16. doi.org/10.1177/0363546517710008 [journals.sagepub.com]

Chaharbakhshi EO, Perets I, Ashberg L, Mu B, Lenkeit C, Domb BG.). Do ligamentum teres tears portend inferior outcomes in patients with borderline dysplasia undergoing hip arthroscopic surgery? A match-controlled study with a minimum 2-year follow-up. The American Journal of Sports Medicine. 2017;45(11)2507-16. [journals.sagepub.com]

Chandrasekaran S, Martin TJ, Close MR, Suarez-Ahedo C, Lodhia P, Domb BG. Arthroscopic reconstruction of the ligamentum teres: A case series in four patients with connective tissue disorders and generalized ligamentous laxity. J Hip Preserv Surg. 2016;3:358-367. doi.org/10.1093/jhps/hnw016 [academic.oup.com , academic.oup.com(PDF)]

de Sa D, Phillips M, Philippon MJ, Letkemann S, Simunovic N, Ayeni OR. Ligamentum teres injuries of the hip: a systematic review examining surgical indications, treatment options, and outcomes. Arthroscopy. 2014;30(12):1634-41. doi.org/10.1016/j.arthro.2014.06.007 [sciencedirect.com]

Dimitrakopoulou A, Villar RN. Surgical Treatment of Specific Hip Conditions: Ligamentum Teres Injuries. In Hip Joint Restoration. New York: Springer, 2017:521-6. [link.springer.com]

Garabekyan T, Chadayammuri V, Pascual-Garrido C, Mei-Dan O. All-arthroscopic ligamentum teres reconstruction with graft fixation at the femoral head-neck junction. Arthrosc Tech. 2016;5(1)e143-7. doi.org/10.1016/j.eats.2015.10.020 [sciencedirect.com]

Hammarstedt JE, Redmond JM, Gupta A, DombBG. Arthroscopic ligamentum teres reconstruction of the hip in Ehlers-Danlos syndrome: a case study. HIP Int.  2015;25(3)286-91. doi.org/10.5301/hipint.5000228 [journals.sagepub.com]

Hartigan DE, Hegedus CE. Editorial Commentary: Ligamentum Teres Reconstruction May Improve Hip Stability But Has High Revision Rates: Fad or Restoration of Function? Arthroscopy. 2021;37(6)1820-1. doi.org/10.1016/j.arthro.2021.02.037 [sciencedirect.com]

Ismailoglu AV, Ismailoglu P, Zeynalov SI, Ozdogmus O, Yildizhan SE, Bayramoglu A, Kayaalp A. A guide to facilitate the creation of a femoral tunnel for arthroscopic ligamentum teres reconstruction: a three-dimensional computed tomography study. Journal of Hip Preservation Surgery. 2023hnad027. doi.org/10.1093/jhps/hnad027 [academic.oup.com , scholar.google]

Knapik DM, Farivar D, Kunze KN, Gilat R, Nho SJ, Chahla J. Indications and outcomes after ligamentum teres reconstruction: a systematic review. Arthroscopy, Sports Medicine, and Rehabilitation. 2021;3(3)e939-49. [arthroscopysportsmedicineandrehabilitation.org ,  sciencedirect.com

Kraeutler MJ, Garabekyan T, Pascual-Garrido C, Mei-Dan O. Ligamentum teres tendinopathy and tears. MLTJ. 2016;6(3)337-42. doi.org/10.11138/mltj/2016.6.3.337 [ncbi.nlm.nih.gov]

Lall AC, Ankem HK, Ryan MK, Beason DP, Diulus SC, Roach RP, Rosinsky PJ, Maldonado DR, Emblton BA, Domb BG. In-line Pullout Strength of 2 Acetabular Fixation Methods for Ligamentum Teres Reconstruction of the Hip: A Cadaveric Study. Orthopaedic Journal of Sports Medicine. 2021;9(12)23259671211052533. doi.org/10.1177/23259671211052533  [journals.sagepub.com]

Lindner D, Sharp KG, Trenga AP, Stone J, Stake CE, Domb BG. Arthroscopic ligamentum teres reconstruction. Arthrosc Tech. 2013;2(1)e21-5. doi.org/10.1016/j.eats.2012.10.002 [sciencedirect.com]

Lindner, D., Gilat, R., & Domb, B. G.). Ligamentum Teres Injuries and Treatment. Hip Preservation Surgery: Open, Arthroscopic, and Endoscopic Techniques. Berlin, Heidelberg: Springer, 2020;181-90. [link.springer.com]

Locks R, Bolia I, Utsunomiya H, Briggs K, Philippon MJ. Current concepts in revision hip arthroscopy. HIP International. 2018;28(4)343-51. doi.org/10.1177/1120700018771927 [journals.sagepub.com]

Maldonado DR, Chen JW, Lall AC, Go CC, Walker-Santiago R, Rosinsky PJ, Shapira J, Domb BG. Arthroscopic Ligamentum Teres Reconstruction Using Anterior Tibialis Allograft and the Tension-Slide Technique. Arthrosc Tech. 2019;8(10)e1075-83. doi.org/10.1016/j.eats.2019.05.022 [sciencedirect.com]

Mazek J, Gnatowski M, Salas AP, Domżalski M, Wójcicki R, Skowronek J, Skowronek P. Ligamentum teres reconstruction with labrum and capsule repair after posterior acetabular wall fracture: a case report. Journal of Hip Preservation Surgery. 2021;8(Supplement_1)i41-i45.  [europepmc.org]

Mazek J, Helmy N, Salas AP, Skowronek P, Madej A, O´Donnell JM, Dimitriou D. Quantitative cotyloid fossa thickness and proximity to obturator neurovascular bundle: implications for arthroscopic ligamentum teres reconstruction. Journal of Hip Preservation Surgery. 2023;10(3-4)192-6. [academic.oup.com , scholar.google]

Mei-Dan O, McConkey MO. A novel technique for ligamentum teres reconstruction with “all-suture” anchors in the medial acetabular wall. Arthrosc Tech. 2014;3(2)e217-21. doi.org/10.1016/j.eats.2013.10.003 [sciencedirect.com]

Menge TJ, Mitchell JJ, Briggs KK, Philippon MJ. Anatomic arthroscopic ligamentum teres reconstruction for hip instability. Arthrosc Tech. 2016;5(4)e737-e742. doi.org/10.1016/j.eats.2016.02.036 [sciencedirect.com]

Neumann JA, Greene RS, Banffy MB. A Technique for Arthroscopic-Assisted Ligamentum Teres Augmentation Using a Suture Tape Augmentation. Arthrosc Tech. 2018;7(1)e65–e69. doi.org/10.1016/j.eats.2017.08.048 [sciencedirect.com]

O’Donnell J, Klaber I, Takla A. Ligamentum teres reconstruction: indications, technique and minimum 1-year results in nine patients. J Hip Preserv Surg. 2020;7(1)140–6. doi.org/10.1093/jhps/hnz070 [academic.oup.com]

O’Donnell JM, Pritchard M, Porthos Salas A, Singh PJ. The ligamentum teres—its increasing importance. J Hip Preserv Surg. 2014;1(1)3-11. doi.org/10.1093/jhps/hnu003 [academic.oup.com , academic.oup.com(PDF)]

Pennock AT, Philippon MJ. Arthroscopic ligamentum teres reconstruction: Technique and Early Outcomes. International Society for Hip Arthroscopy (ISHA) Annual Scientific Meeting.  Cancun, Mexico, Oct 8-9, 2010, P. 62. [drrobertlaprademd.com]

Philippon MJ, Pennock A, Briggs KK. Arthroscopic Ligamentum Teres Reconstruction. International Society for Hip Arthroscopy, Cancun, Mexico, October 2010, P. 65. [drrobertlaprademd.com]

Philippon MJ, Pennock A, Gaskill TR. Arthroscopic reconstruction of the ligamentum teres: technique and early outcomes. J Bone Joint Surg Br. 2012;94B(11)1494-8.  doi.org/10.1302/0301-620X.94B11.28576  [online.boneandjoint.org.uk]

Philippon MJ. Advanced Restorative Concepts: Chondral Grafts, Labrum/ Ligamentum Teres Reconstruction, AANA Specialty Days, 2010 AAOS Annual Meeting. New Orleans, La., March 2010, P. 63. [drrobertlaprademd.com]

Philippon MJ. Arthroscopic Capsular Plication and Ligamentum Teres Reconstruction, Sports Hip Surgery, Warwick, England, June 2010, P.64. [drrobertlaprademd.com]

Philippon MJ. Arthroscopic ligamentum teres repair and reconstruction. Santander Arthroscopy and Sports Hip Meeting. Santander, Spain. February 2009.   [slideshare.net]

Philippon MJ. Arthroscopic Reconstruction of the Ligamentum Teres. Warwick Sports Hip Conference. Warwick, England. October 2006. [slideshare.net , sprivail.org]

Philippon MJ. Ligamentum teres reconstruction. Advances in hip Arthroscopy Meeting. Paris, France. 22-23rd May 2006. [slideshare.net , sprivail.org(PDF)]

Philippon MJ. Ligamentum Teres Reconstruction. Vail Hip Arthroscopy Symposium, Vail, CO, March, 2012. [sprivail.org]

Rosinsky PJ, Annin S, Maldonado DR, Kyin C, Meghpara MB, Shapira J, Lall AC, Domb BG. Arthroscopic ligamentum teres reconstruction: Minimum 2-year patient reported outcomes with sub-analysis of patients with EhlerseDanlos syndrome. Arthroscopy. 2020;36(8)2170-82.  [sciencedirect.com]

Rosinsky PJ, Shapira J, Lall AC, Domb BG. All About the Ligamentum Teres: From Biomechanical Role to Surgical Reconstruction. J Am Acad Orthop Surg. 2020;28(8)e328-e339. doi.org/10.5435/JAAOS-D-19-00352 [journals.lww.com]

Shapira J, Yelton MJ, Rosinsky PJ, Maldonado DR, Meghpara MB, Ankem HK, Lall AC, Domb BG. Ligamentum teres reconstruction may lead to improvement in outcomes following a secondary hip arthroscopy for symptomatic microinstability: A systematic review. Arthroscopy. 2021;37(6)1811-9. doi.org/10.1016/j.arthro.2021.01.022 [sciencedirect.com]

Simpson JM, Field RE, Villar RN. Arthroscopic reconstruction of the ligamentum teres. Arthroscopy. 2011;27(3)436-41. doi.org/10.1016/j.arthro.2010.09.016 [sciencedirect.com

Spencer AD, Hagen MS. Predicting Outcomes in Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Current Reviews in Musculoskeletal Medicine. 2024;1-9. [ncbi.nlm.nih.gov]

Steadman - Hawkins Research Foundation. Annual Report 2006. Vail, Colorado, 2006, P. 60-61. [sprivail.org]

Steadman Philippon Research Institute. 2010 Annual Report. Vail, Colorado, 2010, P. 62-65. [drrobertlaprademd.com]

Steadman Philippon Research Institute. 2012 Annual Report. Vail, Colorado, 2012, P. 35, 57, 64, 66. [sprivail.org]

White BJ, Ericson JrWB. Hip pain: Surgical treatment of an unstable hip: Labral and ligamentum teres reconstruction and periacetabular osteotomy (PAO). In: Francomano CA et al (Eds). Symptomatic. Elsevier, 2024;547-53. [sciencedirect.com]

White BJ, Scoles AM, Herzog MM. Simultaneous acetabular labrum and ligamentum teres reconstruction: a case report. J Hip Preserv Surg. 2018;5(2)166-73. doi.org/10.1093/jhps/hny001 [academic.oup.com]

.                                                                     .

keywords: ligamentum capitis femoris, ligament of head of femur, ligamentum teres, hip joint, reconstruction, arthroscopy …

CATALOGS AND BIBLIOGRAPHIES

Comments

Popular posts from this blog

Great Compilation. Chapter 32

  English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution.  Chapter 32   By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Book of Genesis. Chapter 32 Analysis [iii]   Notes to Chapter 32 [iv]   AI Agent's Conclusion [v]   Content [vi]   External links [vii]   Application [i]   Abstract The Book of Genesis (Bereshith) was compo...

Vertebrates

VERTEBRATES According to the molecular clock, a specific method for dating phylogenetic events, vertebrates (Vertebrata) separated from arthropods (Arthropoda) 976±97 Ma (2004HedgesSB_ShoeJL). The latter began to dominate in species diversity with the Cambrian burst of radiation, which occurred 520 Ma (2010EdgecombeGD). This ratio in the fauna of the Earth is still preserved. Approximately 525 Ma, the phylum Chordates separated from the group of bilaterally symmetrical animals (1995ChenJY_ZhouGQ). In turn, the evolution of chordate organisms led to the formation of the first vertebrates at least 500 Ma, from which the jawed mouths 450-400 Ma descended, becoming the ancestors of the placoderms or "armored" fish (Placodermi) (1979 НаумовНП _ КарташевНН ). Sculptural reconstruction of the placoderm Coccosteus from the order Arthrodires, Middle Devonian, 393.3-382.7  Ma ; exposition of the Orlov Paleontological Museum (Moscow); photo by the author. The first cartilaginou...

Great Compilation. Chapter 41

  English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution.  Chapter 41   By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Book of Genesis. Chapter 41 Analysis [iii]   Notes to Chapter 41 [iv]   AI Agent's Conclusion [v]   Content [vi]   External links [vii]   Application [i]   Abstract The Book of Genesis (Bereshith) was compo...

1605BauhinC

  Fragment from the book Bauhin C. Theatrum anatomicum (1605). The author writes about the attachment, function, possible elongation and damage of the ligamentum capitis femoris (LCF). Lameness after dislocation is mentioned and its cause is explained. In the margins of the page are references to the works of other authors Vesalius , Laurens , Arch ang ( Archangelo Piccolomini ??? ) . Quote p. 1244. Liber IV. DE LIGAMENTIS OSSIS ILII & sacri et que in toto pede habentur. CAP. XXXIX. Femur, coxendicis articulo duplici ligamento nectitur; altero communi membrane, articulum orbiculatim ambit, quod Græci [ischos], totius articuli nomine vocarunt; quod cætera, articulos ambientia crassitie, duritie, & robore su perat, cum articulus hic corpus totum sustinere & motus validos perferre debuerit. Hoc articulo & femoris ceruici accumbit & solum radici magni processus orbiculatim adnascitur, quo motus capitis ipsius femoris non impediantur. Alterum ipsius ligamentum teres...

Great Compilation. Chapter 36

  English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution.  Chapter 36   By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Book of Genesis. Chapter 36 Analysis [iii]   Notes to Chapter 36 [iv]   AI Agent's Conclusion [v]   Content [vi]   External links [vii]   Application [i]   Abstract The Book of Genesis (Bereshith) was compo...

50 TABLES OF EVIDENCE

  Ancient Egypt is the birthplace of the Book of Genesis Arkhipov S.V. 50 Tables of Evidence for the Composition of Genesis in Late Second Intermediate Period Egypt: The Protograph Before the Oral Tradition. Joensuu : Author's Edition, 2026. GGKEY: ZPYTRNR69CB  https://play.google.com/store/books/details?id=Dw7PEQAAQBAJ http://books.google.com/books/about?id=Dw7PEQAAQBAJ ASIN: B0GXWTLSLK https://www.amazon.com/dp/B0GXWTLSLK Synopsis This monograph presents a fundamental revision of the dating and origin of the Book of Genesis , challenging the dominant hypothesis, which dates the text to the mid-first millennium BCE. Through a systematic analysis presented in 50 comparative tables, the author argues that the protograph of Genesis was a deliberate literary compilation created in Egypt during the late Second Intermediate Period (ca. 17th–16th centuries BCE), shortly after the Minoan eruption. The core of the research concerns the non-oral origin of the text. By ident...

Grok. Review of the Article by S.V. Arkhipov "Why Restoration of the Acetabular Labrum May Be Ineffective?".

  At our request, Grok, artificial intelligence developed by xAI, wrote a review of the article by Arkhipov SV. Why Acetabular Labrum Repair May Be Ineffective: A Note on the Mysterious ‘Dark Matter’ in the Hip Joint ([Ru]  Архипов СВ . Почему восстановление вертлужной губы может быть неэффективно?: Заметка о таинственной «темной материи» в тазобедренном суставе. 06.04.2025 ). In accordance with the comments, the article was revised and sent for re-review to the ChatGPT language model prepared to assist in the analysis and editing of texts (OpenAI, 2025).  Below is the original text of the review by Grok: Review of the Article by S.V. Arkhipov "Why Restoration of the Acetabular Labrum May Be Ineffective?: A Note on the Mysterious 'Dark Matter' of the Hip Joint". This review focuses on the analysis of argumentation, as requested. The author asserts that restoration of the acetabular labrum fails to prevent hip joint instability and osteoarthritis when the ligame...

Tweet of Mar 30, 2024

  Mar 30 , 2024 I have published a translation of key parts of the book that laid the foundation for the biomechanics of the hip joint, taking into account the lig.teres: WeberW WeberE Mechanik der menschlichen (1836)  https://roundligament.blogspot.com/2024/03/1836-weberwwebere.html  Welcome to the blog! #ligamentum_teres #biomechanics                                                                                                                     BLOG CONTENT   TWITTER OR X

Pathology of the Nervous and Vascular System LCF

  Version : 20240419 Pathology of the Vascular System OF LCF 1. Arterial thrombosis 2. Phlebothrombosis 3. Embolism 4. Damage to the walls 5. Occlusion 6. Varicose veins 7. Valve dysfunction 8. Atherosclerosis 9. Obliteration 10. Phlebitis 11. Arterial hyperemia 12. Venous hyperemia 13. Devascularization 14. Disappearance of large vessels 15. Decrease in capillary density   Pathology of the Nervous System OF LCF 1. Reducing the number of receptors 2. Disappearance of receptors 3. Selective denervation 4. Total denervation 5. Damage to the corresponding spinal cord nuclei   Keywords: ligamentum capitis femoris, ligament of head of femur , round ligament, ligamentum teres, classification, pathology, vessels, nerves                                                             ...

1679ChartierR

  Fragment from the book Chartier R. (Ed). Operum Hippocratis Coi et Galeni Pergameni archiatron tomus XII (1679). Part of the treatise «Instruments of Reductions» (Mochlicus, Vectiarius) by Hippocrates in Latin and Greek with the mention of ligamentum capitis femoris (LCF). The text is prepared for machine translation using a service built into the blog from Google or your web browser. For a translation of the passage into English, see the link: 1886AdamsF . Quote pp. 536-537. HIPPOCRATIS. MOCHLICUS, SEV VECTIARIUS. Caput I.  Ossa hunc in modum a natura sunt coparata. Digitorum quidem, tum ossiu, tum articulorum, simplex est junctura. In manu vero & pede, cum multa alia varie connectuntur, tu maxima sunt quae supremo loco committuntur. Calcis unum os est, quale foras prominet, quo etiam a posteriore parte tedines tendunt. Tibiae duo ossa sunt supra & infra coherentia, medio vero loco distantia. Quod exterius tendit, parvum & juxta parvum digitum paulo tenuius. Plu...