Hip Osteoarthritis. Pathogenesis

An original view on the pathogenesis of osteoarthritis of the hip joint.

Coxarthrosis is a disease that can develop either independently or against the background of other pathological conditions: congenital hip dislocation, Perthes' disease, aseptic necrosis of the femoral head, and some others. From our point of view, the basis of its pathogenesis, as a rule, is the pathology of ligamentum capitis femoris (LCF). This may involve its complete or partial damage, changes in size, mechanical properties, and the localization of attachment areas.

The pathogenesis of coxarthrosis is a clear illustration of the Law of Bioinduction that we have established. LCF dysfunction results in disruption of normal hip mechanics. In the single-support period of the step and the single-support orthostatic position, it begins to function not as a lever of the second kind, but as a lever of the first kind. Accordingly, only the upper sectors of the femoral head and acetabulum are constantly loaded; the values of the actual average daily stresses in them significantly increase. The bioeffective stresses that arise in this case induce a complex of biological processes.

In the upper sector of the hip joint, the cartilage wears out and becomes thinner. Decentration of the femoral head and its cranial subluxation gradually develop. Microfractures of trabeculae are observed in the bone tissue. The majority of ongoing biological processes aim to neutralize bio-effective stresses. Osteophytes form on the periphery of the articular surfaces, which increases the area of their contact, and at the same time deformation of the articular ends of the bones occurs. The first and second reduce the intensity of internal forces in the bone elements. As the acetabular canal has lost its functional role, the acetabular fossa is eliminated, and the facies lunata expands.

In the subchondral layer of the femoral head, a layer of compact bone tissue appears and gradually thickens, reducing local stresses in the underlying spongy substance. There is a reorientation of the trabecular systems of the proximal end of the femur. The first system of bone trabeculae is strengthened, the second system is eliminated. Bone cysts appear and enlarge as one of the ways to eliminate stresses concentrations inside the bone at the ends of microcracks. The presence of bioeffective stresses is also reflected in soft tissues: fibrosis is observed in tendons, joint capsules and muscles, and in the areas of their attachment there are foci of heterotopic ossification.

There is a shortening of the femoral neck and an increase in the femoral neck-diaphyseal angle. The size and shape of the entire proximal femur changes, and the depth of the acetabulum increases. To a large extent, the listed phenomena are compensatory processes. In some cases, they change the actual average daily stresses, and in others, the optimal average daily stresses; the meaning of both is to level out the existing bioeffective stresses.

The mechanics of a hip joint affected by arthrosis is the mechanics of a hip joint that is devoid of LCF. In this case, the kinematics of locomotion changes significantly and their energy intensity increases. Bioeffective stresses appear not only in the hip joint area, but also in all adjacent elements of the musculoskeletal system, which leads to their pathological changes. With a reduced adaptive potential of tissues and significant violations of the mechanics of the lower limb girdle, bioeffective stresses remain uncompensated. This gradually leads to complete destruction of the hip joint, as well as gross changes in the anatomical elements of adjacent kinematic chains.

Keywords: ligamentum capitis femoris, ligamentum teres, ligament of head of femur, abductor muscle group, hip joint, biomechanics, osteoarthritis, pathogenesis

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

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The first version of the text in:

Архипов-Балтийский СВ. Рассуждение о морфомеханике. Норма. В 2 т. Т. 2. Гл. 5-6. испр. и доп. изд. Калининград, 2004. (Archipov-Baltic SV. Reasoning about Morphomechanics. The norm – Kaliningrad, 2004. [Rus]) [aleph.rsl.ru]

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ETIOLOGY AND PATHOGENESIS

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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. January 05, 2026 2018YoussefAO The article describes a method for transposition of the proximal attachment of the LCF in congenital hip dislocation. 2007WengerD_OkaetR The authors demonstrated in the experiment that the strength of the LCF is sufficient to ensure early stability during hip joint reconstruction in children. January 04, 2026 2008 BacheCE _TorodeIP The article describes a method for transposition of the proximal attachment of the LCF in congenital hip dislocation . 2021PaezC_WengerDR The ar ticle analyzes the results of open reconstruction of LCF in dysplasia. 2008DoddsMK...

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...

IMPROVING POSTOPERATIVE COMFORT...

Improving Postoperative Comfort and Increasing the Reliability of Hip Prostheses by Supplementing with Artificial Ligaments: Proof of Concept and Prototype Demonstration S.V. Arkhipov, Independent Researcher, Joensuu, Finland CONTENT [i] Abstract [ii] Introduction [iii] Materials and Methods [iv] Results and Discussion [v] Static Tests [vi] Dynamic Tests [vii] Prototype Fabrication and Testing [viii] Conclusion [ix] References [x] Application [i] Abstract The principle of operation of an experimental total hip endoprosthesis augmented with ligament analogs has been demonstrated in single-leg vertical stances and at the mid-stance phase of the single-support period of gait. The experiments were conducted on a specially designed mechatronic testing rig. The concept of the important role of the ligamentous apparatus is further illustrated by a set of demonstrative mechanical models. The...

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...

LCF in 2025 (June)

LCF in 2025 ( June ) (Quotes from articles and books published in June 2025 mentioning the ligamentum capitis femoris) Kuhns, B. D., Kahana-Rojkind, A. H., Quesada-Jimenez, R., McCarroll, T. R., Kingham, Y. E., Strok, M. J., ... & Domb, B. G. (2025). Evaluating a semiquantitative magnetic resonance imaging-based scoring system to predict hip preservation or arthroplasty in patients with an intact preoperative joint space. Journal of Hip Preservation Surgery , hnaf027. [i] academic.oup.com Iglesias, C. J. B., García, B. E. C., & Valarezo, J. P. P. (2025) CONTROLLED GANZ DISLOCATION. EPRA International Journal of Multidisciplinary Research (IJMR) - Peer Reviewed Journal. 11(5)1410-13. DOI: 10.36713/epra2013 [ii] researchgate.net Guimarães, J. B., Arruda, P. H., Cerezal, L., Ratti, M. A., Cruz, I. A., Morimoto, L. R., ... & Ormond Filho, A. G. (2025). Hip Microins...

1724FabriciusJA

Fragments from the book Fabricius JA. Bibliothecae Graecae volume duodecimum (1724). The author quotes the Byzantine physician Theophilus Protospatharius, who supposedly lived between the 7th and 10th centuries. Selected passages provide views on the normal anatomy of the ligamentum capitis femoris (LCF) and its inherent connective function. [Grc] θεοφιλος ο Πρωτοσπαθάριος . Περὶ τῆς τοῦ ανθρώπου κατασκευῆς . Βιβλιον Ε . XIII, [p. 892] (see fig.) [Lat] Theophilus Protospatharius. De corporis humani fabrica, Liber quintus, Cap. XIII [p. 892] 1) Dei erga homines amor ex heminae fundo teretem nervum promisit, cartilaginosum vinculum femoris capiti insertum adstringensque, ne facile elabatur:» 2) inde ex heminae oris aliae copulae oriuntur, totum femoris caput in orbem constringentes, non teretes & solae, qualis quae ex fundo porrigitur, sed latae, valenter que heminae oras ad commissurae praesidium ambientes. Translation [Eng] 1) For the sake ...

The author is looking for a laboratory to continue his research

The author is looking for a laboratory to continue his research. Areas for cooperation: - pathogenesis and prevention of coxarthrosis - arthroscopy of the hip joint - hip arthroplasty - reconstruction of the hip joint ligaments - biomechanics of postures and locomotion - classification of ligament pathology - remote diagnostics of hip joint ligament pathology Email: archipovsv@gmail.com Briefly about Sergey Arkhipov Bibliography Experimental material Blog [Rus] Blog [Eng] ResearchGate ORCID Twitter / Х Academia.edu BLOG CONTENT NEWS AND ANNOUNCEMENTS

LCF in English Bibles

The primary source for translating the Bible into English is the Hebrew literary monument Torah. In its first part, the Book of Bereshit (32:33 ) , there is a mention of ligamentum capitis femoris (LCF), which in Hebrew is called « גיד » (gheed, gid) (1923, 2004PreussJ; 2019ArkhipovSV_SkvortsovDV; 2020ArkhipovSV_ProlyginaIV). Probably one of the earliest written translations of the Bible into Old English was made by Ælfric of Eynsham, who worked approximately between 955–1010 CE (1050Aelfric’s). In Aelfric's Anglo-Saxon Paraphrase, the Hebrew concept of « גיד » [gheed], that is, LCF, is mentioned twice in the 25th and 32nd verses of the XXXII Chapter of the Book of Genesis and is called «sine» ( Figure 1, 2 ). In Middle English, translators Nicholas of Hereford and John Wycliffe named LCF as «synwe», and in John Purvey's Bible edition - «senewe» (1850ForshallJ_MaddenF). In Bibles in Early Modern English, LCF is designated as «senow» and «senowe» (1530TyndaleW; 1535CoverdaleM; 1...

Catalog. Classifications of LCF Pathology

The classifications are intended to systematize of ligamentum capitis femoris pathology and assist in the development of general approaches to its description, registration, analysis and treatment. Keywords ligamentum capitis femoris, ligamentum teres, ligament of head of femur, hip joint, histology, pathological anatomy, pathology, trauma INTRODUCTION In Russia, the initial attempts to classify pathology of the ligamentum capitis femoris (LCF) were made by morphologists. 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. 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, as well as a Classification of Functions of the Ligamentum Teres. The ...

190-230Mishnah Chullin

Tractate Mishnah Chullin was written between about 190 - 230 in Israel and discuss laws related to consumption of meat. The selected quotes talk about the presence of ligamentum capitis femoris (LCF) in different animals, its location and distal attachment site. See our commentary at the link: 190-230Mishnah Chullin [Rus]. Quote 1. [Heb] Mishnah Chullin 7:1 (original source: sefaria.org ) Quote 2. [Heb] Mishnah Chullin 7:2 (original source: sefaria.org ) Quote 3. [Heb] Mishnah Chullin 7:3 (original source: sefaria.org ) Quote 4. [Heb] Mishnah Chullin 7:4 (original source: sefaria.org ) Quote 5. [Heb] Mishnah Chullin 7:5 (original source: sefaria.org ) Quote 6. [Heb] Mishnah Chullin 7:6 (original source: sefaria.org ) Translation Quote 1. [Eng] Mishnah Chullin 7:1 The prohibition of eating the sciatic nerve applies both in Eretz Yisrael and outside of Eretz Yisrael, in the presence of, i.e., the time of, the Temple and not in the presence of th...

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