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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Catalog. LCF of Extinct Species

Discussion of the LCF and morphological signs of its existence in extinct species. Funston, G. F. (2024). Osteology of the two-fingered oviraptorid Oksoko avarsan (Theropoda: Oviraptorosauria). Zoological Journal of the Linnean Society, zlae011. [ academic.oup.com ] Hafed, A. B., Koretsky, I. A., Nance, J. R., Koper, L., & Rahmat, S. J. (2024). New Neogene fossil phocid postcranial material from the Atlantic (USA). Historical Biology, 1-20. [ tandfonline.com ] Kuznetsov, A. N., & Sennikov, A. G. (2000). On the function of a perforated acetabulum in archosaurs and birds. PALEONTOLOGICAL JOURNAL C/C OF PALEONTOLOGICHESKII ZHURNAL, 34(4), 439-448. [ researchgate.net ] Romer, A. S. (1922). The locomotor apparatus of certain primitive and mammal-like reptiles. Bulletin of the AMNH; v. 46, article 10. [ digitallibrary.amnh.org , digitallibrary.amnh.org(PDF) ] Słowiak, J., Brusatte, S. L., & Szczygielski, T. (2024). Reassessment of the enigmati...

LCF in 2025 (November)

LCF in 2025 ( November ) (Quotes from articles and books published in October 2025 mentioning the ligamentum capitis femoris) Awad, A., Rizk, A., ElAlfy, M., Hamed, M., Abdelghany, A. M., Mosbah, E., ... & Karrouf, G. (2025). Synergistic Effects of Hydroxyapatite Nanoparticles and Platelet Rich Fibrin on Femoral Head Avascular Necrosis Repair in a Rat Model. Journal of Biomedical Materials Research Part B: Applied Biomaterials , 113 (11), e35672. [i] onlinelibrary.wiley.com Loughzail, M. R., Aguenaou, O., Fekhaoui, M. R., Mekkaoui, J., Bassir, R. A., Boufettal, M., ... & Lamrani, M. O. (2025). Posterior Fracture–Dislocation of the Femoral Head: A Case Report and Review of the Literature. Sch J Med Case Rep , 10 , 2483-2486. [ii] saspublishers.com , saspublishers.com Vertesich, K., Noebauer-Huhmann, I. M., Schreiner, M., Schneider, E., Willegger,...

2025ChenJH_AcklandD

The article by Chen JH, Al’Khafaji I, Ernstbrunner L, O’Donnell J, Ackland D. Joint contact behavior in the native, ligamentum teres deficient and surgically reconstructed hip: A biomechanics study on the anatomically normal hip (2025). The authors experimentally demonstrated the role of the ligamentum capitis femoris (LCF) in unloading the upper sector of the acetabulum and the femoral head. The text in Russian is available at the following link: 2025ChenJH_AcklandD . Joint contact behavior in the native, ligamentum teres deficient and surgically reconstructed hip: A biomechanics study on the anatomically normal hip By Chen JH, Al’Khafaji I, Ernstbrunner L, O’Donnell J, Ackland D. CONTENT [i] Abstract [ii] Introduction [iii] Materials and methods [iv] Results [v] Discussion and Conclusion [vi] References [vii] Application [i] Abstract Background The ligamentum teres is known to contribute to hip joint st...

1816MeckelJF

The author discusses the anatomy and function of the ligamentum capitis femoris (LCF), and also identifies one of the reasons for its damage. The translation was done in collaboration with ChatGPT 3.5. Meckel JF. Handbuch der menschlichen Anatomie. Zweiter Band. Besondere Anatomie. Halle, Berlin: Buchhandlung des Hallischen Waisenhauses, 1816. [fragment] Quote p p . 3 65 -366 c. Runds band §. 948. Gerade vor dem Theile der Synovialhaut, welcher auf der Lücke unter dem brückenförmigen Theile der Knorpellippe liegt, entspringt ein, ungefähr einen Zoll langes, sehr länglichviereckiges Band, das runde Band des Oberschenkels (Ligamentum ossis femoris teres s. rotundum) welches, an beiden Enden etwas ausgebreitet, sich mit seis nem äußern an die Bertiefung im Kopfe des Oberschenkels beines heftet und zu noch größerer Befestigung deffelben beiträgt. Es besteht aus longitudinalen Fasern, welche sich an das obere un...

BIBLICAL DAMAGE

Biblical damage (Artists and sculptors on the LCF damage described in the Bible: painting, sculpture, icon, fresco, engraving…) 386Brescia_Casket Bas-relief. Drawing depicting the circumstances and mechanism of the LCF injury. 6c.Vienna_Genesis Miniature. Drawing depicting the circumstances and mechanism of the LCF injury. 10c.Cross Bas-relief. Drawing depi cting the circumstances and mechanism of the LCF injury. 1000Jacob&Archangel Fresco. Drawing depicting the circumstances and mechanism of the LCF injury. 1050Aelfric Drawing depicting the circumstances and mechanism of the LCF injury. 1140St.Marie-Madeleine Capital. Drawing depicting the circumstances and mechanism of the LCF injury. 1143 Palantine_Chapel Mosaic . Drawing depicting the circumstances and mechanism of the LCF injury. 1213L’histoire_ancienne. M iniature . Drawing depicting the circumstances and mecha...

1832MeckelJF

Fragments of the book Meckel JF. Manual of general, descriptive, and pathological anatomy (1832) dedicated to ligamentum capitis femoris (LCF). The author briefly discusses abnormalities of the LCF and its distal insertion. Quote p. 257 § 308. Among the deviations from the normal state, primitive deviations of the external form are rare, and usually attend anomalies of the other tissues. Among these we arrange, for instance, the absence of the tendons of the abdominal muscles, that of the ligaments of the vertebral column, and that of the dura mater of the brain and spinal marrow, &c., in a congenital fissure of the abdomen, of the vertebral column, and of the skull, and that of the tendons and the muscles of a finger, when the finger itself is wanting. But the fibrous organs are seldom deficient, when the other tissues with which they combine to form a part are present — for instance, the tendon alone of a muscle is rarely absent, or the tunica sclerotica, when the othe...

1884SuttonJB

Fragments from the article Sutton JB. Ligaments: Their Nature and Morphology (1884). The author discovered that in the ostrich the ligamentum capitis femoris (LCF) was not continuous with the ambiens muscle, but with a muscular slip which ran parallel with the-muscle, and ended in the adductor mass. This publication develops the theme of article 1883SuttonJB . Quote pp. 228-229 I must now pass on to consider certain ligaments of the appendicular skeleton, commencing with some additional remarks on the ligamentum teres. The Journal of Anatomy and Physiology, vol. xvii January 1883, contains a short article on the ligamentum teres, in which I have endeavoured to point out that many ligaments are the tender of muscles which were originally in relation with the joint; but the parent muscle has either formed new attachments or become obsolete, whilst the tendon remains as a passive element in the articulation. In addition to the ligamentum teres the following structures ...

1853KnoxR

We publish selected quotations about ligamentum capitis femoris (LCF) from Knox R. Manual of Human Anatomy (1853). The author points out that LCF is a thick and dense bundle of fibers. It is attached to the edges of the acetabular notch and intertwined with the fibers of the fibrocartilaginous ring of the acetabulum. Robert Knox writes: « The functions of the round ligament have not been satisfactorily determined.» Quote p. 142 Fig. 104. - This instructive section of the hip-joint requires little or no explanation. - d points to the superior part of the capsular ligament. Fig. 105. - Capsular ligament of the hip-joint; also Poupart's ligament. - a , the capsular ligament; b , the oblique, or accessory ligament of the joint; d , attachment of the external pillar of Poupart's ligament to the tubercle of the pubis; e , deep structures immediately behind that portion of Poupart's ligament, called the ligament of Gimbernat; c , ligamentum obturatorium. Quo...

The Emergence of Life

THE EMERGENCE OF LIFE According to our definition, life is a way of existence of material objects capable of regulating the level of average daily mechanical stress and reproducing similar entities (2004 Архипов - БалтийскийСВ ). As can be seen, in the given definition there is no reference to protein bodies and organic compounds. Life as a special qualitative state of matter is fundamentally possible not only on the basis of carbon. At the same time, living systems with a different chemistry are unknown, as are extraterrestrial beings. The oldest potentially biogenic carbon on our planet appeared 4.10±0.01 billion years ago, and the simplest living beings appeared 4.1-3.8 billion years ago (2015BellEA_MaoWL). The split of single-celled, anucleate forms of prokaryotes (Procaryota) into bacteria (Eubacteria) and archaea (Archaebacteria) occurred about 4.0 billion years ago (2002HedgesSB). The oldest stromatolites, which are the remains of cyanobacterial communities (Cyanobacteria), bega...

2025VertesichK_ChiariC

Content [i] Annotation [ii] Original text (in German) [iii] References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Fragments from the article: Vertesich K, Noebauer-Huhmann IM, Schreiner M, Schneider E, Willegger M, Böhler C, Windhager R, Chiari C. The position of the femoral fovea can indicate hip instability and highly correlates with lesions of the ligamentum teres: an observational study (2025). The authors discuss the diagnosis of pathology of the ligamentum capitis femoris (LCF) based on radiological & MRI data. The text in Russian is available at the following link: 2025VertesichK_ChiariC . [ii] Original text (in German) The position of the femoral fovea can indicate hip instability and highly correlates with lesions of the ligamentum teres: an observational study Klemens Vertesich, Iris-Melanie Noebauer-Huhmann, Marku...

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