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LCF in 2024 (September)


Publications about the LCF 2024 (September).


Chen, P. L., Lu, Y. H., & Hsieh, C. P. (2024). Hip Arthroscopy-assisted Reduction for Irreducible Hip Dislocation: A Case Report. Formosan Journal of Musculoskeletal Disorders, 15(3), 115-119. [i]  journals.lww.com 


Domb, B. G., Owens, J. S., Lall, A. C., Harris, W. T., & Kuhns, B. D. (2024). Ten-Year Outcomes in Patients Aged 40 Years and Older After Primary Arthroscopic Treatment of Femoroacetabular Impingement With Labral Repair. The American Journal of Sports Medicine, 03635465241270291. [ii] journals.sagepub.com 


Rossi, F. W., Osman, M., & Mormile, I. (Eds.). (2024). Prognostic and Predictive Factors in Autoimmune Connective Tissue Disorders. Frontiers Media SA. [iii] books.google.fi 


Jimenez, R. Q., Walsh, E., & Domb, B. G. (2024). Revision Hip Arthroscopy: Getting It Right the Second Time. Operative Techniques in Sports Medicine, 151108. [iv]  sciencedirect.com 


Gautam V, and Narasimhan R. (2024) Management of developmental dysplasia of the hip in children from 0 to 5 years of age: Retrospective study of cases at a tertiary health care centre. International Journal of Orthopaedics Sciences, 10(3)1-10. [v] orthopaper.com 


Gou, Y., Zhang, Z., Meng, B., Cao, J., Zhu, J., Li, H., & Zhao, Q. (2024). A retrospective study of arthroscopic treatment for patients with bordline developmental dysplasia of the hip. International Orthopaedics, Sept. 1-10. [vi]  link.springer.com 


Rosenbaum, D. G., & Cooper, A. P. (2024). Slipped capital femoral epiphysis: emphasis on early recognition and potential pitfalls. Skeletal Radiology, Sept.  1-12. [vii]  link.springer.com 


LEAL, L. M., SILVA, C. H., JÚNIOR, P. A. C., PAVILAK, G. A., GONÇALVES, M. D., ROMANI, I., ... & MORAES, P. C. (2024). Treatment and Potential Co-occurrence of Hip Subluxation, Patella Alta, and Medial Patellar Luxation in a Canine: Case Report. Acta Vet Eurasia, 50(3)250-254.  [viii]   actavet.org 


Sha, S. Y., Liang, T., Liu, Y., Jin, Q. H., Liu, W. G., & Yin, Q. F. (2024). Proximal Capsular Augmentation With the Indirect Head of the Rectus Femoris for Longitudinal Capsulotomy in Primary Hip Arthroscopy. Arthroscopy Techniques, 103250. [ix]  sciencedirect.com 


Follet, L., Khanduja, V., Thevendran, G., Ayeni, O., Shanmugasundaram, S., Abd El-Radi, M., ... & Audenaert, E. (2024). How to start with hip arthroscopy in a safe and effective manner, using an evidence-based approach. SICOT-J, 10.  [x]  sicot-j.org 


Stetzelberger, V. M., Segessenmann, J. T., Cek, C., Popa, V., Schwab, J. M., Zurmühle, C. A., ... & Tannast, M. (2024). Validation of a computerized model for a new biomechanical concept-the fossa-foveolar mismatch-the answer to lesions of the ligamentous fossa-foveolar complex in the hip?. Archives of Orthopaedic and Trauma Surgery, Sept. 1-9. [xi]  link.springer.com


                                                                    

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[i] During traumatic hip fracture-dislocation, the attainment of concentric reduction in the joint is commonly impeded by the presence of a bony fragment and, less frequently, by injuries to the soft tissues such as a torn acetabular labrum, ruptured capsule, or ligamentum teres.  

Complications in patients who underwent open arthrotomy included a 37% incidence of postoperative heterotopic ossification (HO), along with cases of cosmetic deformity and ligamentum teres rupture.  


[ii] Patients aged ≥40 years had a higher prevalence of ligamentum teres damage (P< .001) and underwent ligamentum teres debridement at higher rates (54% vs 35%; P = .02) as well as higher rates of femoroplasty (74% vs 57%; P = .03).  


[iii] The fibroblasts in patients with AS (ankylosing spondylitis) were obtained from the ligamentum teres of the hip during total hip arthroplasty. 


[iv]  Persistent anterior or lateral hip impingement test might indicate an under resection of Cam or Pincer deformity and a possible re-tear of the labrum, a positive O'Donnell test might indicate ligamentum teres (LT) pathology,… 


[v] Studies show preliminary traction decreasing the incidence of AVN undergoing CR for DDH [20, 21, 22], but any traction will have an insignificant effect on the main obstacles for reduction for eg. pulvinar, tight hour-glass capsule, transverse acetabular ligament, hypertrophied ligamentum teres (all intracapsular).


[vi] Various factors may lead to poor results of hip arthroscopy in BDDH treatment [1, 25, 42]. Studies found that preoperative tearing of the round ligament can lead to lower mental and psychological scores in BDDH patients after hip arthroscopy, making it more difficult to achieve PASS, and significantly increasing the patient’s risk of reoperation or even THA [1, 20].

Patient Acceptable Symptom State (PASS)

Bordline Developmental Dysplasia of the Hip (BDDH)

1. Chaharbakhshi EO, Perets I, Ashberg L, Mu B, Lenkeit C, Domb BG (2017) Do Ligamentum Teres tears portend inferior outcomes in patients with Borderline Dysplasia undergoing hip arthroscopic surgery? A Match-Controlled Study with a Minimum 2-Year follow-up. Am J Sports Med 45:2507–2516.

20. Maldonado DR, Chen SL, Walker-Santiago R, Shapira J, Rosinsky PJ, Lall AC, Domb BG (2020) An Intact Ligamentum Teres predicts a Superior prognosis in patients with Borderline Dysplasia: a matched-pair controlled Study with Minimum 5-Year outcomes after hip arthroscopic surgery. Am J Sports Med 48:673–681


[vii] The femoral head, meanwhile, remains within the acetabulum, constrained by the ligamentum teres, but may rotate to assume a posteroinferior position relative to the shaft.

 

[viii] The primary reported cause is laxity of the soft tissues adjacent to the joint, including the round ligament of the femoral head and laxity of the joint capsule associated with hip dysplasia (Fossum, 2014).

 

[ix] A magnetic resonance imaging scan provides information on labrum and ligamentum teres injuries and reveals the characteristics of the anterior joint capsule.


[x] The ligamentum teres is an around cord-like structure that extends between the cotyloid fossa and the femoral head. 

Fig. 7. Central hip compartment assessment indicates the femoral head (FH), ligamentous teres (A), the posterior labrum (B) and the psoas U-shape groove at the 3 o’clock position.

 

[xi]

Abstract

Background Hip-preserving surgery in young patients frequently reveals lesions of the ligamentum teres (LT). Histological and clinical evidence supports that those lesions could be source of intraarticular hip pain. It has been hypothesized that LT degeneration could be linked to the abnormal positioning of the fovea outside the lunate surface during various daily motions. We introduce the “fossa-foveolar mismatch” (FFM) by determining the trajectory of the fovea in the fossa during hip motions, enabling a comparison across diverse hip-pathomorphologies.

Conclusions The FFM-index showed excellent intraobserver reliability and interobserver reproducibility for all motions. This innovative approach deepens our understanding of biomechanical implications, providing valuable insights for identifying patient populations at risk. 


Fig. 1 The fossa-foveolar mismatch is illustrated by displaying (A) no fossa-foveolar mismatch and (B) presence of a fossa-foveolar mismatch with a pathologic foveolar tracking pattern for the motion of everyday life internal/external rotation in 90 degrees flexion (Commons Attribution 4.0 International)

Fig. 3 (A) Based on CT of the pelvis and distal femur; (B) we created a 3D model; (C) The acetabular fossa was digitally removed; (D) the fovea was identified and manually exaggerated; (E) finally, the model was subjected to standardized movements within physiological range of motion and the foveolar tracking pattern was determined. (Commons Attribution 4.0 International)



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