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Park, C. J., Lee, C. Y., & Park, K. S. (2024) Ligamentum Teres
Injury: Anatomy, Biomechanics, Diagnosis and Treatment. Journal of the Korean
Orthopaedic Association, 59(2), 101-110. [xiv]
jkoa.org
NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7
[i] The femoral
head ligament was typical, extending from the femoral head fovea to the
acetabular fossa [24,25]. (24. König, H.E.; Liebich, H.G.; Maierl, J. Hindlimbs
or pelvic limbs (membra pelvina). In Veterinary Anatomy of Domestic Animals:
Textbook and Colour Atlas, 7th ed.; König, H.E., Liebich H.G., Eds.; Thieme:
Sttutgart, Germany, 2021; pp. 243–303. ;
25. Hermanson, J.W.; Lahunta, A., Evans,
H.E. Arthrology. In Miller and Evans Anatomy of the Dog, 5th ed.; Hermanson,
J.W.; Lahunta, A., Evans, H.E., Eds.; Elsevier: St. Louis, USA, 2020; pp.
375–443.)
[ii] In addition to the capsule and labrum,
there are multiple other contributing factors to the suction seal
including the surrounding joint fluid, ligamentum teres, and extra-capsular muscle tone.
[iii] …
ligamentum teres tear all aided in establishing a diagnosis of
symptomatic hip instability.
[iv] The choice
of treatment tactics was carried out taking into account the type of fracture
according to the Pipkin classification and clinical data. Systematized
according to the following types: – I — dislocation of the hip with a fracture of
the head of the femur below the point of attachment of the round ligament (pit
of the head); – II — dislocation of the hip with a fracture of the head of the
femur above the point of attachment of the round ligament; – III — type I or II
in combination with a femoral neck fracture; – IV — type I or II together with
a fracture of the acetabulum.
[v] The ligament of the femoral head, also known as ligamentum teres, originates from the obturator crest and
inserts into fibrous capsule of the hip joint.
[vi] Recent
research suggests that the development of cam morphology is related to the
repetitive shear stresses experienced at the hip joint during adolescence from
skating. This condition likely
increases the potential for intra-articular and extra-articular injuries in
these athletes later in their careers. Research also indicates that the hip
joint mechanics during forward skating substantially increase the possibility
of sustaining a labral tear compared to other sports. Such an injury can
increase femoral head movement within the joint, potentially causing secondary
damage to the iliofemoral ligament, ligamentum teres and joint capsule. These
injuries and the high density of nociceptors in the affected structures may
explain the high prevalence of hip and groin pain in hockey athletes.
The most common hip pathologies observed in elite
hockey athletes include: femoroacetabular impingement (FAI), injuries to the
non-contractile tissues including the labrum, iliofemoral ligament (IFL), and
ligamentum teres (LT), as well as muscular injuries, such as core muscle
injuries (CMI), hip flexor, and adductor injuries.
[vii] Introduction.
This study aims to evaluate the histology of the
ligamentum teres and its relationship with matrix metalloproteinases (MMPs) and
a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), which
are involved in the destruction of extracellular matrix proteins in patients
with developmental dysplasia of the hip (DDH).
Conclusions. The histological
structure of ligamentum teres in patients with DDH shows moderate inflammation,
fibrosis, neovascularization, hyalinization, and fatty infiltration regardless
of age and radiological stage. ADAMTS-7, MMP-2, and MMP-9 correlate positively
with the histological parameters of the ligamentum teres in patients with DDH.
[viii] The femoral head
is approximately rounded and features a shallow pit known as the capital ligament
fossa (as shown in Fig. 4I).
[ix] [There is an]
… oblique ligament groove on the femoral head…
[x] The hip is
further stabilized by static and dynamic stabilizers, including the
fibrocartilaginous labrum, ligamentous hip capsule, ligamentum teres, and the
musculature that courses across the hip joint.
[xi] Table 2 - The top 100 cited articles on hip arthroscopy.
25 |
Catastrophic failure of hip arthroscopy due to iatrogenic instability:
can partial division of the ligamentum teres and iliofemoral ligament cause
subluxation? |
Mei-Dan O |
Arthroscopy: The Journal of Arthroscopic and Related Surgery |
Millennium Institute of Sport and Health |
New Zealand |
2012 |
35 |
Tears of the ligamentum teres
prevalence in hip arthroscopy using 2 classification systems |
Botser IB |
The American Journal of Sports
Medicine |
Hinsdale Orthopedic Associates |
USA |
2011 |
![]() |
Figure 4. The top 20 keywords with the strongest citation bursts. (Creative Commons CC BY, no change). |
[xii] At 6 weeks of age (mean weight = 10.6 ± 1.8 kg,
range = 8.1–14.5 kg), piglets underwent surgery to induce complete (100%)
ischemia of the epiphysis of the femoral head by placement of a ligature around
the femoral neck and transection of the ligamentum teres.
…
Complete femoral head ischemia was confirmed in 10/11 piglets as
determined by the complete absence of signal enhancement on subtracted CE-MRI.
One piglet had partial femoral head ischemia and thus was excluded from the
data analysis. In all cases, femoral head ischemia was limited to the epiphysis
of the femoral head, whereas the metaphysis was perfused.
[xiii] The head of the femur is oriented
medially and slightly ventrally in anterior view (Fig. 2A1). It has a rounded,
semicircular outline, but poor preservation makes interpretation of other
features difficult. For example, there appears to be a distinct ligament groove
on the anterior surface extending parallel to the medial margin of the process,
but this could be the result of erosion or damage as there is no cortical bone
in this area.
[xiv] Abstract.
In the past, the ligamentum teres of the hip joint
was considered as a vestigial structure and its removal during surgical
procedures was deemed acceptable. However, with the recent advancements in hip
arthroscopy, there has been an increased interest in ligamentum teres injuries.
This has led to various studies revealing notable characteristics of this
ligament. The purpose of this review article is to describe the role of the
ligamentum teres as a stabilizing factor in the hip joint, focusing on its anatomical
and biomechanical characteristics. In addition, by identifying the causes of
ligamentum teres injuries, we aim to present appropriate diagnostic methods and
treatment approaches. Ultimately, we intend to provide comprehensive guidelines
for the ligamentum teres injuries.
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