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

21cent.bcBaqetIII

Groups of wrestlers on the walls of tomb BH15, belonging to Baqet III – a contemporary of Pharaoh Mentuhotep II (frescoes, Beni Hasan, Egypt). These images depict wrestling scenes and the circumstances under which injuries to the hip joint — including the ligamentum capitis femoris (LCF) — might occur. The frescoes appear to have served as the basis for the description of wrestling found 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: Nint...

MEDICAL RECORD. Title and contents

Book manuscript: Arkhipov S.V. Medical Record: The Contribution of a Middle Bronze Age Egyptian Physician to the Book of Genesis. Kyrö : Author’s Edition, 2026. – 312 pp. – 2 tables. – Bibliographical references: 856 entries. Google Books ID: GGKEY:5GXG1LS275N , play.google.com , books.google.com Title, Abstract and Contents CONTENT [i] Abstract [ii] Dedication [iii] Book Covers and Title [iv] Table of Contents [v] Application [i] ABSTRACT Before you is the final medical record compiled by the author over a professional career as an orthopaedic surgeon. This work outlines information regarding a patient who sustained a hip joint injury in the Middle Bronze Age. The source material is extracted from the Book of Genesis and cross-referenced with facts from history, archaeology, natural science, and medicine past and present. Along the way, it is demonstrated that the protograph was composed in Ancient Egypt during the Second Intermediate P...

20cent.bcAmenemhet

Groups of wrestlers on the walls of tomb BH2, belonging to Amenemhat (Ameni)—a contemporary of Pharaoh Senusret I (frescoes, Beni Hasan, Egypt). These images depict wrestling scenes and the circumstances under which injuries to the hip joint—including the ligamentum capitis femoris (LCF)—might occur. The frescoes appear to have served as the basis for the description of wrestling found 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...

Tweet of October 26, 2026

The new book about the first patient with a #ligamentum_teres injury. PDF: http://books.google.com/books/about?id=OcogEgAAQBAJ Manuscript: https://roundligament.blogspot.com/2026/10/medical-record-title-and-contents.html Tweet of October 26, 2026 #Bible #Genesis BLOG CONTENT TWITTER OR X

1893GriffithFL

Griffith F.L. (1893): A group of wrestlers on the wall of the tomb of Baqet III (fresco, late 20th century BCE, Egypt). A depiction of the circumstances surrounding a hip joint injury—possibly involving the ligamentum capitis femoris (LCF) – which served as the basis for the description of a wrestling match 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 ) and Medical Record (2026Ar...

MEDICAL RECORD. Chapter 2

Book manuscript: Arkhipov S.V. Medical Record: The Contribution of a Middle Bronze Age Egyptian Physician to the Book of Genesis. Kyrö: Author’s Edition, 2026. – 312 pp. – 2 tables. – Bibliographical references: 856 entries. play.google.com , books.google.com Introduction Chapter 2 Chronology of the Medical Record CONTENT [i] Text [ii] Navigation [iii] Application [i] Text When reading the Book of Genesis , we learn that the first recorded patient with an injury to the ligament of the head of femur was a man named Ya'akov (Gen. 32:25, 33). In adapted usage, the name is rendered as Jacob. According to the narrative, he was born near the well of Beer-Lahai-Roi, between Kadesh and Bered in the Negev Desert, which is in the south of the "Canaanite" land (Gen. 16:14, 23:19, 24:62). As is clear from the text, the "Canaanite land" is the western part of the current State of Israel, excluding the vicinity of the Jordan River (Gen. 13:11–12). Jacob's father ...

NEWS 2026

New publications of our resource in 2026 The initial phase of collecting data on LCF, accumulated prior to the 20th century, is largely complete. Next, we plan to analyze and synthesize thematic information, adding data from the 20th and 21st centuries. The work will focus primarily on: prevention, diagnosis, arthroscopy, plastic surgery, and endoprosthetics. October 29 , 2026 22cent.bcBaqetI . Fresco. A depiction of the circumstances surrounding a hip joint injury. October 28 , 2026 17cent.Akrotiri . Fresco. A depiction of the circumstances surrounding a hip joint injury. 20cent.bcAmenemhet . Fresco. A depiction of the circumstances surrounding a hip joint injury. 20cent.bcKhety . Fresco. A depiction of the circumstances surrounding a hip joint injury. 21cent.bcBaqetIII . Fresco. A depiction of the circumstances surrounding a hip joint injury. October 26 , 2026 Tweet of October 26, 2026 . Book announcement 1893GriffithFL Fresco. A depi...

MYTHS AND MISCONCEPTIONS

MYTHS AND MISCONCEPTIONS ( Erroneous and folkloric beliefs, folk and traditional stories...) LCF in English Bibles The first written mention of the LCF in humans is found in the ancient Hebrew book – Bereshit (Genesis). In English translations of the Bible, LCF is denoted by various terms, often not explicitly referring to the «ligament». The Shortest Comments on Genesis, Chap. XXXII-XXXIII In the selected excerpt, the symptoms, mechanism, and differential diagnostic test for the injury to LCF are provided, along with details about the circumstances, time, and place of the biblical trauma. 1609-1583bcProtoBereshit Hypothesis: in the work of fiction, an unknown physician-encyclopedist for the first time pointed out damage to the LCF as a cause of gait disturbance. 922-722bcElohist A variant of the oldest description of damage to the LCF and the cause of lameness in Hebrew, dating from 922-722 BC. 8cent.bcHomer The...

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...

Human Children. Retelling of Chapter 5

Short retelling of chapter 5 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 5. ADAM AND EVE The Book of Genesis narrates the story of a tribe founded by Adam and Eve, described as the "mother of all living." From a genetic perspective, they are depicted as siblings, with an age difference of 18–25 years. According to the biblical epic, they formed humanity’s first family, sustaining themselves on pre-existing fruits and seeds. Their initial home was the "garden in Eden," located "in the east" relative to the narrator. The text identifies geographic markers for Eden’s location: lands like "Asshur," "Cush," and "Havilah," and rivers named "Pishon," "Gihon," "Hiddekel," and "Phrath." The narrator also notes the region’s economic value, mentioning "gold," ...

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