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.

BLOG CONTENT

CATALOGS AND BIBLIOGRAPHIES

Comments

THE GIFTS OF THE MAGI FOR ORTHOPEDIC SURGEONS

Translation of the article: Архипов СВ. Новая техника проксимального крепления при реконструкции ligamentum capitis femoris: Дары волхвов ортопедическим хирургам. The text in Russian is available at the following link: 2026АрхиповСВ . A Novel Technique for Proximal Fixation of Ligamentum Capitis Femoris Reconstruction: The Gifts of the Magi for Orthopedic Surgeons S.V. Arkhipov, Independent Researcher, Joensuu, Finland CONTENT [i] Abstract [ii] Introduction [iii] Materials and Methods [iv] Technique [v] Discussion [vi] Conclusion [vii] Appendix [viii] References [ix] Structured Abstract [x] Additional material [i] Abstract An experimental technique for reconstruction of the ligamentum capitis femoris (ligamentum teres femoris) is described. The proposed method involves creating two portions of the ligament analog: a pubic portion and an ischial portion. Fixation of thes...

1970MichaelsG_MatlesAL

Content [i] Annotation [ii] Original text [iii] References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Abstract of the article: Michaels G, Matles AL. The role of the ligamentum teres in congenital dislocation of the hip (1970). The authors proposed an analogy for the role of the ligamentum capitis femoris (LCF) as a “ball and chain control” and noted that it can spontaneously reduce congenital hip dislocation. The text in Russian is available at the following link: 1970MichaelsG_MatlesAL . [ii] Original text Quote p. 199 Many papers in the literature have implicated the ligamentum teres as a hindrance to the late open reduction of a congenitally dislocated hip. Occasionally the ligamentum teres has been reported to be absent. However, in most cases it is hypertrophied and elongated. Our present knowledge confirms the fact that congenital dislocation of t...

2025SarassaC_HerreraAM

Content [i] Annotation [ii] Original text [iii] References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Abstract of the article : Sarassa C. et al . I ntraosseous Tunneling and Ligamentum Teres Ligamentodesis “Teretization” to Enhance S tability in Congenital Hip Dislocation Surgery: Surgical Technique and Mid-Term Outcomes (2025). The article describes a technique for fixing the femoral head using the ligamentum capitis femoris (LCF) in congenital hip dislocation. The text in Russian is available at the following link: 2025SarassaC_HerreraAM . [ii] Original text Abstract Background Developmental dysplasia of the hip (DDH) with complete dislocation (grade ≥III) in older patients often requires open reduction. However, achieving long-term stability remains challenging. This study introduces and evaluates a novel surgical technique, intraosseous tunneling ...

2018YoussefAO

Content [i] Annotation [ii] Original text [iii] References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Abstract of the article: Youssef AO. Medial approach open reduction with ligamentum teres partial excision and plication for the management of congenital hip dislocation (2018). The article describes a method for transposition of the proximal attachment of the ligamentum capitis femoris (LCF) in congenital hip dislocation. The text in Russian is available at the following link: 2018YoussefAO . [ii] Original text Abstract Because of the known tendency for early redislocation following open reduction, we developed surgical methods for shortening the ligamentum teres to improve immediate postoperative stability when performing medial approach open reduction (MAOR) for the management of developmental dysplasia of the hip. Between 2004 and 2014, 32 patients w...

2008WengerDR_MiyanjiF

Article: Wenger DR et al. Ligamentum teres maintenance and transfer as a stabilizer in open reduction for pediatric hip dislocation: surgical technique and early clinical results (2008). The article describes a method of open reconstruction of the ligamentum capitis femoris (LCF) for hip dysplasia. The text in Russian is available at the following link: 2008WengerDR_MiyanjiF . Ligamentum teres maintenance and transfer as a stabilizer in open reduction for pediatric hip dislocation: surgical technique and early clinical results Wenger DR, Mubarak SJ, Henderson PC, Miyanji F CONTENT [i] Abstract [ii] Introduction [iii] Materials and Methods [iv] Surgical technique & Results [v] Discussion & Conclusion [vi] References [vii] Application [i] Abstract Purpose The ligamentum teres has primarily been considered as an obstruction to reduction in children with developmental dislocation of the hip (DDH). In the ea...

Full access to the PDF version of the book: HUMAN CHILDREN

Full access to the PDF version of the book is now available: Arkhipov S.V. Human Children: The Origins of Biblical Legends from a Physician's Perspective. An essay with references to interactive materials. 2nd revised and expanded edition. Joensuu: Author's Edition, 2025. (In Russian)]. Google Play , Google Book , drive.google.com , kruglayasvyazka.blogspot.com [Архипов С.В. Дети человеческие: истоки библейских преданий в обозрении врача. Эссе, снабженное ссылками на интерактивный материал. 2-е изд. перераб. и доп. Йоэнсуу : Издание Автора , 2025.] Annotation The first version of the Book of Genesis appeared in Ancient Egypt approximately 3,600 years ago, during the Hyksos period. The work was conceived as a fairy tale epic. An unknown physician-encyclopedist, who is also presumed to have authored the Edwin Smith Papyrus, played a role in its composition. He supplemented the co-author's family legends, retellings of halluc...

2012MansmannKA

Invention (Patent Application Publication): Mansmann KA. Tendon-sparing implants for arthroscopic replacement of hip cartilage. WO2012162571A1 (2012). The original text of the document contained defects. WO2012162571A1S US Inventor: Kevin A. Mansmann Worldwide applications 2012 WO Application PCT/US2012/039481 events: 2012-05-24 Application filed by Mansmann Kevin A 2012-11-29 Publication of WO2012162571A1 Tendon-sparing implants for arthroscopic replacement of hip cartilage Kevin A. Mansmann Abstract Surgical implant devices are disclosed which will allow completely arthroscopic resurfacing of the acetabular socket, and the femoral head, in hip joints, in both humans, and in animals such as dogs. Such devices, made of flexible polymers with smooth articulating surfaces and porous anchoring surfaces, can be provided with centered openings, to allow a surgeon to spare the major ligament (the ligamentum teres) which connects the femoral head to the pelv...

1753TarinP

Fragments from the book Tarin P. Ostéo-graphie (1753). The author notes the localization of ligamentum capitis femoris (LCF) and uses synonyms: ligament rond, ligamentum teres capitis femoris. The text is prepared for machine translation using a service built into the blog from Google or your web browser. Quote p. 24 Les Ligamens de l'extrémité inférieure sont, 1°. la Membrane capsulaire, &c. de la cavité cotyloïde, le Ligament rond, l'Appareil ligamenteux propre à cette cavité; le Ligament transveríal interne de son bord, le transversal externe, les deux Ligamens glanduleux; … Quote p. 54. Illæ tres offeæ portiones simul unitæ Cavitatem cotyloïdeam q.t. a. constituunt, in qua occurrit Foveols h. glandulas synoviales articulationis excipiens, cuique sesc inserit ligamentum teres capitis femoris, &c. Vid. t. u. v. TAB. I. II. III. External links Tarin P. Ostéo-graphie, ou Description des os de l'adulte, du foetus, &c. Precedée d'une introduction a l'etu...

Who, When, and Where Wrote the Book of Genesis?

Who, When, and Where Wrote the Book of Genesis? A Medical Hypothesis By Sergey V. Arkhipov, MD, PhD & Lyudmila N. Arkhipova, BSN CONTENT [i] Abstract [ii] Introduction [iii] Egyptian physician [iv] Asian diviner [v] Conclusion [vi] References [vii] Application [i] Abstract The Book of Genesis is an example of an ancient literary text that contains important medical insights. We propose that it was written in northern Egypt in the late 17th century BCE, approximately ten years after the Minoan eruption. The protograph likely emerged from the collaboration between an Asiatic seer, who rose to the rank of an Egyptian official, and an Egyptian physician-encyclopedist. By refining its dating and authorship, this hypothesis positions Genesis as a credible source of medical and historical data, thereby enhancing its value for interdisciplinary research. [ii] Introduction According to Rabbinic Judais...

Key Role of the LCF

In the experiments conducted on the pelvis-femur-muscle-ligaments model, we found that when the contralateral pelvic drop occurs, the ligament of the head of femur become maximally tense; simultaneously, there is relaxation and lengthening of the gluteus medius muscle; the pelvis spontaneously rotates towards the stance limb (forward), and the load on the hip joint decreases. Thanks to the functioning of the ligament of the head of femur the walking is smooth, rhythmic, and energy-efficient. Track Music: Blue Dot Sessions , Vittoro (CC BY-NC 4.0 DEED / fragment) "Take care of the ligament of the head of femur for yourself and your neighbor!" . . keywords: ligamentum capitis femoris, ligament of head of femur, ligamentum te...

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