Set of Classifications

General Classification of LCF Pathology

Version: 20240420

Annotation

Analysis of literature data and our own morphological observations allowed us to propose a General Classification of LCF Pathology.

Introduction

In Russia, the initial attempts to classify pathology of the ligamentum capitis femoris (LCF) were made by morphologists. L.I. Gaevskaya distinguished three types of LCF: 1) long and thick (length 41–51 mm, thickness 5 mm), 2) short and thin (length 10–20 mm, thickness 1 mm), 3) long and of small thickness (length 43–45 mm, with a thickness of 3 mm, and length 28–30 mm with a thickness of 4–5 mm) (1954ГаевскаяЛИ). V.V. Kovanov, A.A. Travin identified three varieties of histological structure of LCF: 1) with a predominance of loose connective tissue; 2) with a predominance of dense connective tissue; 3) with a uniform distribution of loose and dense connective tissue (1963КовановВВ_ТравинАА).

The development of arthroscopic surgery has made it possible to identify various, previously undescribed types of LCF pathology, which prompted the development of various modern classifications based on intraoperative observations (1997GrayAJ_VillarRN; 2001RaoJ_VillarRN; 2010CerezalL_Pérez-CarroL; 2011BotserIB_DombBG; 2015SalasAP_O'DonnellJ M; 2017DevittBM_O'DonnellJM; 2018O'DonnellJM_AroraM). Analysis of literature data and our own morphological observations allowed us to propose a General Classification of the Ligamentum Teres Pathology, which has the form of a collection of classifiers (2020ArkhipovSV), as well as a Classification of Functions of the Ligamentum Teres (2020ArkhipovSV). The classification is intended to systematize pathology of LCF, assist in the development of general approaches to its description, registration, analysis, and treatment.

LCF pathology may be caused by local processes and injuries, as well as by diseases of the entire body, individual organs, or systems. Due to this, the systematic classification of all possible changes is challenging. In our collection, we have used terminology accepted in medicine and biology, applying term elements from various classifications: systematic, histological, morphological, traumatological, topographic, and functional.

Catalog. General Classification of LCF Pathology

DOMAINS OF LCF PATHOLOGY

TYPES OF LCF PATHOLOGY

CHARACTER OF LCF PATHOLOGY

FACTORS CAUSING OF LCF PATHOLOGY

VARIANTS OF LCF PATHOLOGY

PHASES OF LCF PATHOLOGY

LOCALIZATION OF LCF PATHOLOGY

LOCALIZATION OFPATHOLOGY IN THE DISTAL ATTACHMENT AREA OF LCF

LOCALIZATION OFPATHOLOGY IN THE PROXIMAL ATTACHMENT AREA OF LCF

LOCALIZATIONOF PATHOLOGY IN THE DISTAL PART OF LCF

LOCALIZATION OFPATHOLOGY IN THE PROXIMAL PART OF LCF

TYPE OF LCF INJURY

SUBTYPE OF LCF INJURY

MECHANISM OF LCF INJURY

DIRECT MECHANISM OF LCF INJURY

INDIRECT MECHANISM OF LCF INJURY

COMBINED MECHANISM OF LCF INJURY

ENERGY OF LCF INJURY

LCF INJURIES FROM THE TYPE OF ITS DEFORMATION

MAIN TYPES OF LCF INJURY

SUBTYPE OF COMPLETE LCF INJURY

SUBTYPE OF PARTIAL LCF INJURY

MORPHOLOGY OF LCF

HISTOLOGICAL CHARACTERISTICS OF LCF ATTACHMENT SITES

Pathology of the Vascular System OF LCF

Pathology of the Nervous System OF LCF

Typesof LCF Infection

VARIETIES OF LOCAL INFECTIOUS INVOLVEMENT OF LCF

RESULT OF PATHOLOGICAL CHANGE OF LCF

PATHOMORPHOLOGICAL CHANGES OF LCF

NECROSIS OF LCF

METAPLASIA OF LCF

Neoplasms OF LCF

CHARACTERISTICS OF LCFCHANGES

CHANGESIN THE MECHANICAL PROPERTIES OF LCF

CHANGING THE SPATIAL POSITION OF LCF

CHANGING OF GEOMETRICAL PROPERTIES OF LCF

PATHOLOGY OF LCF ATTACHMENT AREAS

Types of Pathology of LCF Attachment Area

Variants of Pathology of LCF Attachment Area

Pathology of the Distal Attachment Area of LCF

TOPOGORAPHY OF THE ACETABULAR CANAL

PATHOLOGY OF THE ACETABULAR CANAL

MAIN FUNCTIONS OF LCF

Effects of the Mechanical Function of LCF

ALTERNATIVE TYPES OF LCF FUNCTIONS

FUNCTIONS OF LCF

Degrees of LCF Function Performance

TYPES OF LCF DYSFUNCTIONS

Magnitude of LCF Load

Reasons for Increased Load on LCF

Reasons for Decreased Load on LCF

TYPES OF LCF RECONSTRUCTION

SUBTYPES OF LCF RECONSTRUCTION

Conclusion

We believe that the use of the provided classifiers will allow for a more comprehensive description of LCF pathology, aid in determining rational methods of treatment and restoration of its function, and assist in predicting the outcomes of hip joint diseases and injuries.

References

Гаевская ЛИ. Топографо-анатомические особенности связочного аппарата тазобедренного сустава и их значение для клиники: дис. ... канд. мед. наук. Ленинград, 1954.

Кованов ВВ, Травин АА. Хирургическая анатомия нижних конечностей. Москва, 1963. [1lib.sk]

Arkhipov SV. Classification of functions of the ligamentum teres. Ligamentum teres - ligamentum incognitum. 07.06.2020. DOI:10.13140/RG.2.2.32089.34403 [researchgate.net]

Arkhipov SV. General classification of the ligamentum teres pathology. Vers. 2.0.1, 41 sections, 343 paragraphs and subparagraphs. Update: 07.06.2020. DOI:10.13140/RG.2.2.25378.45769 [researchgate.net]

Botser IB, Martin DE, Stout CE, Domb BG. Tears of the ligamentum teres: prevalence in hip arthroscopy using 2 classification systems. Am J Sports Med. 2011;39(1):117S-25S. [journals.sagepub.com]

Cerezal L, Kassarjian A, Canga A, Dobado MC, Montero JA, Llopis E, Pérez-Carro L. Anatomy, biomechanics, imaging, and management of ligamentum teres injuries. Radiographics. 2010;30(6):1637-51. [pubs.rsna.org]

Devitt B.M., Smith B., Stapf R., Jo S., O’Donnell JM: The reliability of commonly used arthroscopic classifications of ligamentum teres pathology. J Hip Preserv Surg 2017;4(2):187-93. [scholar.google]

Gray AJ, Villar RN. The ligamentum teres of the hip: an arthroscopic classification of its pathology. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 1997;13(5):575-8. [sciencedirect.com]

O’Donnell JM, Devitt BM, Arora M. The role of the ligamentum teres in the adult hip: redundant or relevant? A review. Journal of hip preservation surgery 2018;5(1):15-22. [academic.oup.com]

Rao J, Zhou YX, Villar RN. Injury to the ligamentum teres: mechanism, findings, and results of treatment. Clin Sports Med 2001;20(4):791-9. [sportsmed.theclinics.com]

Salas AP, O’Donnell JM. Ligamentum teres injuries - an observational study of a proposed new arthroscopic classification. J Hip Preserv Surg. 2015;2(3):258-264. [ncbi.nlm.nih.gov]

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, classification, pathology

External links

Arkhipov SV. General Classification of LCF Pathology; Version: 20240420. About round ligament of femur (ligament of head of femur), 2024.04.20. [roundligament.blogspot.com]

In translating to English, the author is assisted by ChatGPT (version 3.5) and the Google Translate service.

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Memorial Day

July 7 My Father's Day Vasily Dmitrievich Arkhipov (1936-2004) Tireless Worker of the Kindest Soul The engineering mindset inherited from him helped develop a Theory of ligamentum capitis femoris biomechanics , create mechanical models of the hip joint , and design walking machines with ligaments analogues . Jubilee Promo: Our Books at €1 Архипов С.В. Связка головки бедренной кости. Функция и роль в патогенезе коксартроза. Йоэнсуу: Издание Автора, 2023. [Arkhipov SV. The ligament of the head of femur. Function and role in the pathogenesis of coxarthrosis. Joensuu: Author's Edition, 2023. (In Russian)] Google Play Архипов С.В. Девятый месяц, одиннадцатый день: Рассуждение о XXXII главе книги Бытие. Йоэнсуу: Издание Автора, 2024. [Arkhipov S.V. The Ninth Month, Eleventh Day: A Reflection on Chapter XXXII of the Book of Genesis. Joensuu: Author’s Edition, 2024. (In Russian)] GooglePlay Архипов С.В. Дети человеческие: истоки библейских преданий в обозрении врача. Эссе, снабже...

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...

1155Abenezra

Content [i] Annotation [ii] Original text [iii] English translation [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Fragment from the book: Ezra AM. Ibn Ezra’s Commentary on the Pentateuch. Genesis (Bereshit) (1155). The author discusses the interpretation of the term gid ha-nasheh denoting ligamentum capitis femoris (LCF) in the book of Bereshit. The text in Russian is available at the following link: 1155Abenezra . [ii] Original text Bereshit 32:33 ( sefaria.org ) [iii] English translation Genesis 32:33 THE SINEW OF THE THIGH-VEIN. The meaning of the term gid ha-nasheh (the sinew of the thigh-vein) is known from the tradition received and transmitted to us by the Talmudic sages.49 No one but those lacking in understanding and knowledge of nature have any doubt as to its definition. The latter interpret gid (sinew) to refer to the penis and h...

LCF in 2026 (June)

LCF in 2026 (June ) (Quotes from articles and books published in June 2026 mentioning the ligamentum capitis femoris) Turner, A. H., Kernan, C. E., Laing, A., Pritchard, A. C., Stocker, M. R., Irmis, R. B., ... & Nesbitt, S. J. (2026). A new shuvosaurid (Archosauria, Poposauroidea) from the Late Triassic (Norian) Hayden Quarry of New Mexico, USA. Journal of Vertebrate Paleontology , e2618182. [i] tandfonline.com Wang, F., Mu, Y., Sun, J., & Chi, H. Traumatic necrosis of femoral head: a case report. Journal of Clinical Medicine Research. 2026;7(1)14-18. [ii] en.front-sci.com Sha, S. Y., Lang, X. X., Liu, Y., Li, C. B., & Yin, Q. F. L‐Capsulotomy and Anatomic Repair of Zona Orbicularis: Hip Arthroscopy Capsular Management for Femoroacetabular Impingement Syndrome. Arthroscopy Techniques , e70149. [iii] arthroscopyjournals.onlinelibrary.wiley.com Garlapaty, A. R....

1900BetheE

Fragments of t he book Pollux J. Onomasticum (166-76) edited by E. Bethe (1900). In Greek the author calls ligamentum capitis femoris (LCF) «ἰσχίον», and the concept of «ligament» is designated by the term «νεῦρον / ν εῦρα ». The term «ἰσχίον» was used by Rufus of Ephesus ( 2020ArkhipovSV_ProlyginaIV ). The fragment of the Onomasticum dealing with the LCF was quoted by Giovanni Filippo Ingrassia ( 1603IngrassiaeIP ) . See our commentary at the link: 1900 BetheE [Rus]. Quote 1. Βιβλίου Β. 186-187 [Grc] καιλεῖται δὲ καὶ τὸ νεῦρον τὸ σ υνέχον τὴν κοτύλην πρὸ σ τὸν μηρὸν ἰ σ χίον. ὁμώνυμον δ’ ἐ σ τιν αύτῷ καὶ τὸ ἄρθρον. καὶ τὸ μὲν [τῇ] κοτύλῃ [ σ υνηρμο σ μένον] ὀ σ τοῦν σ τρογγύλον μηροῦ κεφαλὴ, μηρὸ σ δὲ τὸ ἁπ ὸ το ύ το υ μὲχρ ι γονάτων μὲρο σ , … (original source: 1900BetheE , pp. 140-141 ) Quote 2. Βιβλίου Β. 234 [Grc] Νεῦρα δ’ ἐστι σύνδεσμος ὀστῶν εἴκων τε καὶ τεινόμενος, ἀφ ̓ ὧν κ...

LCF in 2026 (May)

LCF in 2026 (May ) (Quotes from articles and books published in May 2026 mentioning the ligamentum capitis femoris) Kim, P. S., Kang, C., Lee, J. K., & Hwang, J. M. (2026). Hip arthroscopy to treat symptomatic paralabral cysts: a retrospective analysis of clinical outcomes. Arthroscopy and Orthopedic Sports Medicine , 13 (1), 27-34. [i] e-aosm.org Ko, H. Y. (2026). Vascular Anatomy of the Extremities and Lungs. In Practical Functional Anatomy for Spinal Cord Injury Rehabilitation: A Guide for Physiatrists and Rehabilitation Specialists (pp. 191-223). Singapore: Springer Nature Singapore. [ii] link.springer.com Aiba, H., Yamaguchi, M., Kimura, H., & Murakami, H. (2026). Advances in limb-salvage surgery and reconstruction for pediatric bone and soft tissue tumors. Frontiers in Pediatrics , 14 , 1817788. [iii] pmc.ncbi.nlm.nih.gov Bajwa, A., Villar, R., ...

1632Hamburg

Unknown Master, tapestry from Hamburg – Jacob wrestling with the angel (1632). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Ja cob was left alone; and there wrestled a man with him until the breaking of the day. 26 And when he saw that he could not prevail against him, he struck against the hollow of his thigh ; and the hollow of Jacob's thigh was put out of joint, as he was wrestling with him. … 33 Therefore do the children of Israel not eat the sinew which shrank, which is upon the hollow of the thigh, unto this day; because he struck against the hollow of Jacob's thigh on the sinew that shrank. ( 1922LeeserI , Genesis (Bereshit) 32:25-26,33) More about the plot in our work: Ninth month, eleventh day ( 2024 АрхиповСВ. Девятый месяц, одиннадцатый день ). Unknown Master, tapestry from Hamburg – Jacob wrestling with the angel (1632); original i...

17c.Archangel_Cathedral

Archangel Cathedral of the Moscow Kremlin, fresco – «Jacob’s Wrestling with God» (1652 – 1666). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Ja cob was left alone; and there wrestled a man with him until the breaking of the day. 26 And when he saw that he could not pre vail against him, he struck against the hollow of his thigh ; and the hollow of Jacob's thigh was put out of joint, as he was wrestling with him. … 33 Therefore do the children of Israel not eat the sinew which shrank, which is upon the hollow of the thigh, unto this day; because he struck against the hollow of Jacob's thigh on the sinew that shrank. ( 1922LeeserI , Genesis (Bereshit) 32:25-26,33) More about the plot in our work: Ninth month, eleventh day ( 2024АрхиповСВ. Девятый месяц, одиннадцатый день ). Unknown author – Archangel Cathedral of the Moscow Kremlin, fr...

1974SchwartzDL_HallerJAJr

Fragments of the article Schwartz DL, Haller JAJr. Open anterior hip dislocation with femoral vessel transection in a child (1974). Authors report damage to the ligamentum capitis femoris (LCF). Summary This is a case report of a 5-year-old girl who sustained an open anterior hip dislocation with complete transection of the femoral artery and vein following blunt trauma. Her preoperative evaluation and operative care are described, along with a 1-year follow-up. Major vascular damage in children with blunt trauma is emphasized. Quote 1. 3) The left femoral head and its attached ligamentum teres were avulsed from deep within the acetabulum, and protruded through the mid-portion of the gaping groin wound (Fig. 2). Quote 2. After removal of large segments of free bone chips and debridement of obviously crushed muscle, the femoral head and its attached ligamentum teres were reduced. External links Schwartz DL, Haller JAJr. Open anterior hip dislocation with femoral vessel transectio...

1990HarveyB

Harvey B, sculpture, Jacob wrestling with the angel (ca. 1990). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Ja cob was left alone; and there wrestled a man with him until the breaking of the day. 26 And when he saw that he could not pre vail against him, he struck against the hollow of his thigh ; and the hollow of Jacob's thigh was put out of joint, as he was wrestling with him. … 33 Therefore do the children of Israel not eat the sinew which shrank, which is upon the hollow of the thigh, unto this day; because he struck against the hollow of Jacob's thigh on the sinew that shrank. ( 1922LeeserI , Genesis (Bereshit) 32:25-26,33) More about the plot in our work: Ninth month, eleventh day ( 2024АрхиповСВ. Девятый месяц, одиннадцатый день ). Bessie Harvey – tree root sculpture Jacob Wres tling with the Angel (ca. 1990); original in the high.org collection (Fair...

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