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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CATALOGS AND BIBLIOGRAPHIES

Comments

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., ...

Human Children. Retelling of Chapter 1

Short retelling of chapter 1 of the essay: Arkhipov S.V. Human Children: The Origins of Biblical Legends from a Physician's Perspective. Joensuu: Author's Edition, 2025. [In Russian] Chapter 1. THE BEGINNING OF THE WORLD The Bible stands as a remarkable testament to religious and philosophical thought, passed down through the ages with minimal alterations. At its core lies a collection of texts rooted in the sacred writings of Jewish and Samaritan traditions, known as the Torah, meaning "Law" or "Teaching." In its narrowest sense, the Torah comprises the first five books of the Hebrew Bible, collectively called the Tanakh—an acronym derived from the Hebrew terms for "Law/Teaching" (Torah), "Prophets" (Nevi’im), and "Writings" (Ketuvim). Beyond this Written Torah, there exists an Oral Torah, which includes the Mishnah, Talmud, and Midrash, offering interpretations and expansions of the written texts. The Written Torah it...

1851HyrtlJ

The author expresses a classic view on the functions of the ligamentum capitis femoris (LCF): a conductor of blood vessels and a limiter of adduction of the femur. J. Hyrtl believed that it was impossible to completely dislocate the hip without tearing the LCF. Hyrtl J. Lehrbuch der Anatomie des Menschen, mit Rücksicht auf physiologische Begründung und praktische Anwendung. Wien: W. Braumüller, 1851. [fragment] Quote p. 265 In der Höhle des Gelenks liegt das runde Band des Schenkelkopfes (Lig. teres), welches an der Incisura acetabuli entspringt, und bei richtiger Neigung des Beckens, senkrecht zur Grube des Schenkelkopfes aufsteigt. Es beschränkt dieses Band die Zuziehung des Schenkels, und schreibt zugleich den durch die Incisura acetabuli eindringenden Blutgefässen den Weg vor, den sie zum Oberschenkelkopfe zu nehmen haben. Da das Band, wenn es in die Höhle des Gelenkes vorragen würde, durch Reibung viel zu leiden hätte, so...

1730CheseldenW

Fragments from the book Cheselden W. The Anatomy of the Human Body (1730). The author draws attention to the role of ligamentum capitis femoris (LCF) in counteracting hip dislocation and maintaining the femoral head in the joint. The work notes that the LCF is “powerful” and “short” - “about two inches” i.e. approximately 5 cm! This error will be corrected in a subsequent treatise ( 1733CheseldenW ) . Quote pp. 43 - 44 Chap. VII. Of the Ligaments At the upper part of the articulation of the Os Femoris and Os Innominatum, is a strong ligament of great consequence; it contributing very much to preserve that joint from being luxated by the weight of the body. And from the lower edge of the Acetabulum of the Os Innominatum, runs a ligament to the middle of the head of the Os Femoris, about two inches long (which the Motion in this joint requires) called Teres, or Rotundum, whose use is to prevent the Os Femoris from being luxated upwards, but down wards it will le...

2019(a)ArkhipovSV_SkvortsovDV

Ligamentum capitis femoris: first written mentions S.V. Arkhipov, D.V. Skvortsov SUMMARY Background. A ligamentum capitis femoris (syn. ligamentum teres) is one of the least studied anatomical structures. We know little about its role in the musculoskeletal system, and even less about its first written mentions. Purpose. This article is intended to clarify who and when first described the connection of the head of the femur in the medical literature, and to provide a hypothesis about its first mention in the history of mankind. Material and methods. We reviewed the oldest written sources available to us, covering the anatomy of the hip joint and ligamentum capitis femoris. Conclusion. The first description of the ligamentum capitis femoris in the medical text is given by Hippocrates of Kos in the treatise Instruments of Reductions (V-IV century BC). According to our hypothesis, the first in the history of mankind to mention a ligamentum capitis femoris, is cont...

16th Century

16th Century Catalog of archived publications of the specified period 1500-1509 1510-1519 1510Leonardo_da_Vinci In the drawing, a uthor depicted the distal fragment of the LCF. 1520-1529 1521Berengario da CarpiJ The author comments on the treatise by Mondino de Luzzi, describes the form, role and symptoms of LCF damage. 1527BenedettiA The author explains the origin of the rare synonym of LCF – ischion. 1530-1539 1540-1549 1541MondinoL_DryanderJ An early description of the anatomy and role of the LCF is presented. 1541PolluxJ In Greek the author calls LCF «ἰσχίον», and the translator designates the concept of «ligament/sinew» with the term «neruus». 1543(a)VesaliusA The author describes the anatomy, attachment, properties and role of LCF, also interprets its synonyms. 1543(b)VesaliusA The author describes the attachment and shape of the LCF. 1544GuidiG The author p...

Signet ring

Signet ring , bas-relief – Jacob wrestling with an angel. Variant of 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 ( 2024 АрхиповСВ. Девятый месяц, одиннадцатый день ). https://www.familysealrings.com/Faith-Rings.html Signet ring , bas-relief – Ja...

1877MorrisH

An excerpt from the article by Morris H. Dislocations of the Thigh: their mode of occurrence as indicated by experiments, and the Anatomy of the Hip-joint (1877, pp. 161-170). The author noted that the ligamentum capitis femoris (LCF) is stretched during flexion, adduction, and external rotation. It was found that the LCF is always damaged in hip dislocations, is more often torn from the femur, and is rarely ruptured. Discussion of article see article 1877BrookeC . DISLOCATIONS OF THE THIGH: THEIR MODE OF OCCURRENCE AS INDICATED BY EXPERIMENTS AND THE ANATOMY OF THE HIP-JOINT. BY HENRY MORRIS, M.A., M.B., F.R.C.S., ASSISTANT SURGEON TO, AND LECTURER ON ANATOY1 AT, THE MIDDLESEX HOSPITAL. Received January 9th-Read February 13th, 1877. RECENTLY, whilst making various dissections of the hip-joint, the usually accepted doctrine that dorsal and ischiatic dislocations of the femur occur when the thigh is in a position of adduction appeared to me as very improbable, on anatomi...

1849QuainJ

Fragments from the book by Jones Quain (fifth edition): Elements of anatomy Vol. 1 (1849), the first edition was published in 1828. The author writes about the anatomy of the ligamentum capitis femoris (LCF) and mentions synonyms. Quote p. 278 THE HIP-JOINT. This is a true ball-and-socket joint, in which the globular head of the femur is received into the acetabulum or cotyloid cavity. The articulating surfaces are covered by cartilage in the greater part of their extent. It is deficient, however, at the bottom of the cavity, and also a little beneath the central point of the head of the femur; the latter marking the insertion of the round ligament, the former a shallow fossa for the lodgment of the structure which has been called the synovial gland. The connecting means in this articulation are three ligaments, viz. a capsular, cotyloid, and interarticular ligament, together with a synovial membrane. Fig. 147. Ligaments of the pelvis and hip-joint. The view is t...

18th Century

18th Century Catalog of archived publications of the specified period 1700-1709 1705PetitJL The author writes about anatomy, role, and damage of the LCF in hip dislocation. 1705RuyschF The author describes the anatomical preparation containing the LCF, notes its areas of attachment, geometric and mechanical properties. 1706PolluxJ The author refers to LCF as "νεῦρον" and also points out the synonym "ἰσχίον". 1709PetitJL The author discusses the anatomy, role and damage of the LCF in hip dislocation, and also mentions the principle of treatment. 1710-1719 1715MunnicksJ The author describes the attachment, shape, role of the LCF, and discusses subluxation of the hip. 1717HermannD The author indicates the distal area of attachment of the LCF and uses a rare synonym. 1720-1729 1720RuyschF The author draws attention to the well-developed blood supply of the acetabular fossa, as well as the ...

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