UNDERWATER ROCK OF THE RECONSTRUCTIONS

UNDERWATER ROCK OF THE LIGAMENTUM TERES RECONSTRUCTIONS

Sergey V. Arkhipov

Dedicated to reconstructors of ligamentum teres...

INTRODUCTION:

Our colleagues made a wonderful presentation: LT_PHILIPdoNOTlostIT_dicatate.mov, Philip Rosinsky et al., - Thanks!

PURPOSE:

Here I would like to recall one of the underwater rock on the way of the ligamentum teres reconstructions.

PREMISS:

Distribution of forces in the hip joint in the monopodial standing position and in the single limb stance phase of normal gait is complicated and not obvious.

Fig.1 Distribution of forces in the single limb stance phase of normal gait (Arkhipov S.V., 2019)

PROBLEM:

What is the load on the ligamentum teres?

CONDITIONS OF THE PROBLEM:

Acceleration of gravity, g = 9.8 m / s²

Overall of the body mass = 58.7 kg, see experiment of O.Fischer (Pauwels F, 2012, P.86)

Body mass (single limb support period) according to Fischer O. = 47.76 kg (Pauwels F., 2012, P.86)

The maximum dynamic component is the 17th phase of the step (dynamic force) +24.35 kg (Pauwels F., 2012, P.87)

Lever arm of the body weight = 0.1099 m (Pauwels F., 2012, P.83)

Lever arm of the abductor muscles = 0.04 m (Pauwels F., 2012, P.85)

Kapandji A.I.(2009): m. gluteus medius can develop force - 16 kg, m. gluteus minimus - 4.9 kg, m.

tensor fascia lata - 7.6 kg; i.e. in total the abductor muscle group can develop generate = 28.5 kg.

Diameter of the femoral head = 0.05 m (circa)

Fossa acetabulum depth 0.01 m (circa)

Bottom thickness of the fossa acetabulum = 0.003 m (circa)

SOLUTION OF THE PROBLEM:

Rule of moments for a single support step period Arkhipov S.V. (2019):

PL = F_abL_ab + F_ltL_lt

Body weight ((body mass + dynamic force) × g) in the 17th phase of the step:

P = (47.76 + 24.35) × 9.8 = 706.68 N

Lever arm of the ligamentum teres (half diameter of the femoral head + fossa acetabulum depth + Bottom thickness of the fossa acetabulum):

L_lt = 0.05/2 + 0.01 + 0.003 = 0.038 m

Abductor force (pull of the abductor muscle × g):

F_ab = 28.5 × 9.8 = 279.3 N

The ligamentum teres load:

F_lt = (PL - F_abL_ab) / L_lt

F_lt = (77.66 - 11.17) / 0.038 = 1749.74 N

UNDERWATER ROCK:

The loading of the ligamentum teres during walking may be equivalent 178.54 kg, that is 3 times more of the overall body mass.

QUESTION:

Fig. 2 Presentation of the Rosinsky P. et al., 2019 (video: right – 01 m. 13 s. ; left – 01 m. 18 s.)

Can this thread, button and bottom of the acetabulum withstand a load of 178.54 kg and how long?

ACKNOWLEDGMENTS

My good wishes for success to colleagues: Philip Rosinsky, Jacob Shapira, Ajay C. Lall, and Benjamin G. Domb.

References

1. Rosinsky P., Shapira J., Lall A.C., Domb B.G. (2019) LT_PHILIPdoNOTlostIT_dicatate.mov. Retrieved December 23, 2019. from researchgate.net

2. Arkhipov S.V. (2019, September 22) New Biomechanics of the Hip Joints: Ligamentum Teres as a Functional Relation. Part I. Pictorial Essay. Ligamentum Teres – Ligamentum Incognitum. Vol. 0, № 0, pp. 1–25. Retrieved December 23, 2019. from ligteres.com

3. Pauwels F. Biomechanics of the locomotor apparatus: contributions on the functional anatomy of the locomotor apparatus. Berline [etc.], Springer Science & Business Media, 2012.

4. Kapandji A.I. The physiology of the joints: Lower limb. Vol. 2, 5th ed. New Delhi: Elsevier Exclusive, 2009.

The article was first published in 2019 (December 23) on the website www.ligteres.com, copy:

Arkhipov SV. Underwater Rock of the Ligamentum Teres Reconstructions. Ligamentum Teres – Ligamentum Incognitum. 2019, December 23:1-3. doi.org/10.13140/RG.2.2.22632.42249 [researchgate.net]

keywords: ligamentum capitis femoris, ligament of head of femur, ligamentum teres, arthroplasty, reconstruction…

BLOG CONTENT

SURGERY

Comments

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) (1954 ГаевскаяЛИ ). 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 ( 1963 КовановВВ _ ТравинАА ). The development of arthroscopic surgery has made it possible to i...

Topography of the Acetabular Canal

Version : 20250728 Topography of the Acetabular Canal Side Femoral (lateral) Pelvic (medial) Contents Synovial fluid Ligamentum capitis femoris (LCF) White adipose tissue Loose connective tissue Synovial membrane Transverse acetabular ligament Arteries Veins Nerves Lymphatic vessels Sections Peripheral section Central section Subsynovial section Suprasynovial section Peripheral Section Entrance foramen -- Upper edge -- Lower edge -- Anterior edge -- Posterior edge External segment (subligamentous) - Superior wall - Inferior wall - Posterior wall - Anterior wall Internal segment (extraligamentous) - Subsynovial part (tier) -- Superior wall -- Inferior wall -- Posterior wall -- Anterior wall - Suprasinovial part (tier) -- Superior wall -- Inferior wall -- Posterior wall -- Anterior wall Central Section Iliac recess Ischial recess Subsynovial part (tier) - Outer margin - Medial wall - Lateral wall - Anteroinferior wall - Posteroinferior wall - Supra...

LCF in 2025 (July)

LCF in 2025 ( July ) (Quotes from articles and books published in July 2025 mentioning the ligamentum capitis femoris.) Tekcan, D., Bilgin, G., & Güven, Ş. Evaluation of Risk Factors for Developmental Dysplasia of the Hip. HAYDARPAŞA NUMUNE MEDICAL JOURNAL , 65 (2), 99-103. [i] jag.journalagent.com Domb, B. G., & Sabetian, P. W. (2025). Greater Trochanteric Pain Syndrome: Gluteal Tendinopathy, Partial Tear, Complete Tear, Iliotibial Band Syndrome, and Bursitis. In Orthopaedic Sports Medicine (pp. 1-17). Springer, Cham. [ii] link.springer.com Kuhns, B. D., Becker, N., Patel, D., Shah, P. P., & Domb, B. G. (2025). Significant Heterogeneity in Existing Literature Limits Both Indication and Outcome Comparability Between Studies Involving Periacetabular Osteotomy For Acetabular Dysplasia With or Without Arthroscopy Despite Improvement for Both: A Systematic Review. Arthroscopy . [iii] ...

1864MacalisterA

Content [i] Annotaction [ii] Original in English [iii] Translated into German [iv] Illustrations [v] Source & links [vi] Notes [vii] Authors & Affiliations [viii] Keywords [i] Annotaction Fragment of the article: Macalister A. On the anatomy of the ostrich (Struthio camelus) (1864). The author observed ligamentum capitis femoris (LCF) in an ostrich. Its strength is noted, and its shape is described. Translation into Russian is available at the link: 1864MacalisterA . [ii] Original in English Quote, p. 22 The articulations of the lower extremity present many points of mechanical importance. The first, or the hip, is an enarthrosis, surrounded by a capsule, loose, expanding inferiorly; the synovial membrane spreads over the great trochanter; a strong transverse band passes from the border of the lesser sciatic notch to the upper and posterior edge of the acetab...

1857HyrtlJ

The author discusses the anatomy, structure, and role of the ligamentum capitis femoris (LCF). Based on his own research, Josef Hyrtl asserts that the vessels of the LCF do not participate in supplying blood to the femoral head. The author highlights the high strength of the LCF and changes in congenital dislocations. Apparently, this work was the first to suggest that the LCF serves as a conductor of inflammatory processes and a cause of coxalgia. Hyrtl J. Handbuch der topagraphischen Anatomie und ihrer praktisch medicinisch-chirurgischen Anwendungen. Zweiter band. Wien: W. Braumüller, 1857. [fragment] Quote p. 410-412 c. Rundes Band des Schenkelkopfes. Einfluss desselben auf die Stellung des Beins bei Coxalgie. Ein verticaler, durch die Mitte der Pfanne und des Schenkelkopfes und bei richtiger Beckenneigung von aussen nach innen geführter Schnitt, trennt das runde Band in zwei gleiche Schenkel, einen vorderen und hinteren. Das Band ...

1835CooperAP

Fragments of the book Cooper AP. Lectures on the Principles and Practice of Surgery (1835) dedicated to ligamentum capitis femoris (LCF). The author discusses LCF injury during hip dislocation and notes the important role of its blood vessels in supplying the femoral head. Quote p. 577 DISLOCATIONS OF THE HIP JOINT … It generally happens when the thighs are widely separated from each other, that the ligamentum teres and capsular ligament are torn through, and the head of the bone is situated on the obturator externus muscle at the inner and back part of the thigh. Quote pp. 584-585 ON DISLOCATIONS OF THE THIGH BONE … But the third and principal reason is, the almost entire absence of ossific union in the head of the bone when detached from its cervix. The principal supply of blood to the head of the bone being derived from the ligamentum teres, which has only a few minute vessels ramifying from it on the bone, the natural supply of blood for the neck and head ...

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...

1930ShagallM

Shagall M, gouache, Jacob wrestling with the angel ( after 1930) . 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 ). Moishe Shagall – Jacob Wrestling with the Angel (after 1930); original in the chiesadimilano.i...

17c.BambiniN

Bambini N, painting – Jacob Wrestling with the Angel (17th – 18th cent.). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Jacob 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 ). Niccolò Bambini – Jacob Wrestling with the Angel (17th – 18th cent.); original in the...

1290Egerton1066

Miniature Jacob Wrestling with the Angel from Egerton 1066 (ca. 1270 – 1290?). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Jacob 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 ). Initial E from Egerton 1066 – Jacob Wrestling with the Angel (ca. 1270 – 1290?) original ...

Search This Blog