2024MiglioriniF

2024MiglioriniF_MaffulliN

Abstract and table 4 (overview of LCF tear classification) of the article Migliorini F et al. The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review. (2024). Translation into Russian is available at the link: 2024MiglioriniF_MaffulliN.

Systematic Review / Open access / Published: 20 December 2024

The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review

Filippo Migliorini, Federico Cocconi, Tommaso Bardazzi, Virginia Masoni, Virginia Gardino, Gennaro Pipino, Nicola Maffulli

Journal of Orthopaedics and Traumatology volume 25, Article number: 68 (2024)

Abstract

Background

The ligamentum teres (LT) has received attention in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). Indeed, a better understanding of the function of the LT and its implications for clinical outcomes in the presence of a torn LT is required. This systematic review analyses the patient-reported outcome measures (PROMs) and the complication rate when an intact or torn LT is encountered during HA for FAI.

Methods

Studies that compared patients with an intact to those with a torn LT managed with debridement during hip arthroscopy for FAI were identified from the Web of Science, PubMed, and Embase. The minimum follow-up for inclusion was 24 months. The Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool was used to assess the risk of bias. Patient characteristics and PROMs were assessed at the baseline and last follow-up.

Results

The systematic review identified two studies comprising 611 patients. No statistically significant difference was found in pain, Harris Hip Score, and the activities of daily living and sports subscales of the Hip Outcome Score between patients with an intact LT and those with a torn LT treated with debridement, both of whom underwent HA for FAI.

Conclusions

In patients undergoing arthroscopic management for FAI, an intact or torn ligamentum teres managed with debridement does not influence postoperative PROMs. Given the importance of the LT as a structure of the hip joint and the increasing interest in HA for FAI, further standardised studies will be a valuable source for surgeons encountering this pathology.

Table 4 Overview of LT tear classification

Author classification group	LT pathological alteration and grade
Domb classification [68]	I: normal II: partial tears (< 50%) III: partial tears (> 50%) IV: complete tears
Gray and Villar [13]	I: complete rupture (major trauma) II: partial rupture (minor trauma) III: degenerative—partial or complete (attritional)
Salas and O’Donnell [89]	I: LT synovitis II: LT synovitis with impingement III: partial LT tear—low grade IV: partial LT tear—high grade (50%) V: partial LT tears with hip osteoarthritis VIa: complete LT tear—acquired VIb: complete LT tear—avulsion fracture VIc: complete LT tear—congenital absence
O’Donnell and Arora [30]	0: normal I: synovitis II: partial tear III: complete tear

References

13. Gray AJ, Villar RN (1997) The ligamentum teres of the hip: an arthroscopic classification of its pathology. Arthroscopy 13(5):575–578. https://doi.org/10.1016/s0749-8063(97)90182-1 Article CAS PubMed Google Scholar

30. O’Donnell JM, Arora M (2018) A novel and simple classification for ligamentum teres pathology based on joint hypermobility. J Hip Preserv Surg 5(2):113–118. https://doi.org/10.1093/jhps/hnx039 Article PubMed Google Scholar

68. Botser IB, Martin DE, Stout CE, Domb BG (2011) Tears of the ligamentum teres: prevalence in hip arthroscopy using 2 classification systems. Am J Sports Med 39(Suppl):117s–125s. https://doi.org/10.1177/0363546511413865 Article PubMed Google Scholar

89. Porthos Salas A, O’Donnell JM (2015) Ligamentum teres injuries—an observational study of a proposed new arthroscopic classification. J Hip Preserv Surg 2(3):258–264. https://doi.org/10.1093/jhps/hnv045 Article Pub

Open Access This article is licensed under a Creative Commons Attribution 4.0 http://creativecommons.org/licenses/by/4.0/.

External links

Migliorini, F., Cocconi, F., Bardazzi, T., Masoni, V., Gardino, V., Pipino, G., & Maffulli, N. (2024). The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review. Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology, 25, 68. jorthoptraumatol.springeropen.com.

Authors & Affiliations

Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy

Filippo Migliorini, Federico Cocconi & Tommaso Bardazzi

Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy

Filippo Migliorini

Department of Orthopaedics and Traumatology, University of Turin, Via Zuretti, 29, 10126, Turin, Italy

Virginia Masoni

Department of Orthopaedics and Traumatology, University of Bologna, Via G. Cesare Pupilli, 1, 40136, Bologna, Italy

Virginia Gardino

Department of Orthopaedics, Villa Erbosa Hospital, San Raffaele University, Milan, Italy

Gennaro Pipino

Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy

Nicola Maffulli

Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke on Trent, ST4 7QB, UK

Nicola Maffulli

Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK

Nicola Maffulli

Keywords

ligamentum capitis femoris, ligamentum teres, ligament of head of femur, role, classification, pathology, review

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

BLOG CONTENT

REVIEWS AND CLASSIFICATIONS

21st Century

Comments

Test catalog of the LCF pathology

Test catalog of the ligamentum capitis femoris pathology By Sergey V. Arkhipov, MD, PhD CONTENT [i] Abstract [ii] Introduction [iii] Testing in the supine position [iv] Testing in a standing position [v] Gait study [vi] References [vii] Application [i] Abstract A description of tests for the detection and differential diagnosis of ligamentum capitis femoris (LCF) pathology is presented. [ii] Introduction One of the first studies devoted to the diagnosis of LCF injury demonstrated a variety of symptoms: groin pain, hip stiffness, sometimes long-standing minimal clinical findings, or signs similar to osteoarthritis (1997GrayA_VillarRN). More than a decade later, researchers concluded: "Unfortunately, there is no specific test for detecting LCF tears." The signs known at that time were nonspecific and were also observed in other intra-articular pathologies of the hip joint (2010CerezalL_Pérez-CarroL). The a...

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...

Who, When, and Where Wrote the Book of Genesis?

Who, When, and Where Wrote the Book of Genesis? A Medical Hypothesis By Sergey V. Arkhipov, MD, PhD & Lyudmila N. Arkhipova, BSN CONTENT [i] Abstract [ii] Introduction [iii] Egyptian physician [iv] Asian diviner [v] Conclusion [vi] References [vii] Application [i] Abstract The Book of Genesis is an example of an ancient literary text that contains important medical insights. We propose that it was written in northern Egypt in the late 17th century BCE, approximately ten years after the Minoan eruption. The protograph likely emerged from the collaboration between an Asiatic seer, who rose to the rank of an Egyptian official, and an Egyptian physician-encyclopedist. By refining its dating and authorship, this hypothesis positions Genesis as a credible source of medical and historical data, thereby enhancing its value for interdisciplinary research. [ii] Introduction According to Rabbinic Judais...

1836-1840PartridgeR

«Prof. Partridge in his lectures on anatomy at King's College was accustomed to compare the Ligamentum Teres, in its function, to the leathern straps by which the body of a carriage is suspended on springs » ( 1874SavoryWS ). Perhaps Nikolai Pirogov listened to these lectures ( 1859PirogoffN ). The analogy that Richard Partridge used could have arisen after reading the monograph Bell J. The Principles of Surgery (1801) . In it, the author depicted a cart and a pelvis resting on the head of one and two femurs. However, there is no mention of ligamentum capitis femoris (LCF) in the chart descriptions. References Savory WS. On the use of the ligamentum teres of the hip joint. J Anat Physiol. 1874;8(2)291-6. [ ncbi.nlm.nih.gov , archive.org ] Pirogoff N. Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductus illustrate. Petropoli: Typis Jacobi Trey, 1859. [ books.google , archive.org ] ...

2025SrinivasanS_SakthivelS

The article by Srinivasan S, Verma S, Sakthivel S. Macromorphological Profile of Ligamentum Teres Femoris in Human Cadavers–A Descriptive Study (2025) is devoted to the morphology of ligamentum capitis femoris (LCF) in the Indian population. The text in Russian is available at the following link: 2025SrinivasanS_SakthivelS . Macromorphological Profile of Ligamentum Teres Femoris in Human Cadavers–A Descriptive Study By Srinivasan S, Verma S, Sakthivel S. CONTENT [i] Abstract [ii] Introduction [iii] Materials and Methods [iv] Results and Discussion [v] Conclusion [vi] References [vii] Application [i] Abstract Introduction: The ligamentum teres femoris (LTF) is an intra-articular ligament extending from fossa of acetabulum to the head of femur and is triangular or pyramidal in shape. Recent literature supports its role as a secondary stabilizer of hip and increasing evidence supports reconstructive surgery following tear...

2024GillHS

Content [i] Annotation [ii] Original text [iii] Illustrations & References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Article by Gill HS. CORR Insights: How Strong Is the Ligamentum Teres of the Hip? A Biomechanical Analysis (2024). To clarify the role of ligamentum capitis femoris (LCF), the author recommends a combination of experimental studies with computer modeling. The text in Russian is available at the following link: 2024GillHS [ii] Original text Where Are We Now? Hip preservation surgery has seen a rapid increase in usage over the last 15 years [10], in large part driven by the groundbreaking work of Ganz et al. [5], who described the association between femoroacetabular impingement and hip osteoarthritis and who also developed effective methods of surgical dislocation that maintain the blood supply to the femoral head [4]. Arthroscopic met...

1996ChenHH_LeeMC

Abstract of the article Chen HH, Li AF, Li KC, Wu JJ, Chen TS, Lee MC. Adaptations of ligamentum teres in ischemic necrosis of human femoral head (1996). The authors investigate the strength of the ligamentum capitis femoris (LCF) in avascular necrosis and femoral neck fracture. The text in Russian is available at the following link: 1996ChenHH_LeeMC . Annotation Little is known about the biomechanical properties of human ligamentum teres. To more fully understand the ligamentum teres, its dimensions and mechanical properties were measured in 22 cases of acute fracture of the femoral neck and 21 cases of ischemic necrosis of the femoral head. The specimens first were preconditioned and then loaded to failure with a testing machine at a fast strain rate of 100% s(-1). The ischemic necrosis group had a significantly larger volume (3.09 +/- 1.81 ml versus 1.30 +/- 0.62 ml) and cross section area (65.3 +/- 59.1 mm2 versus 30.6 +/- 27.2 mm2) than did the acute f...

2025ArkhipovSV. Physicians Who Became Gods

The English translation of the artistic etude by Sergei Arkhipov « Врачи , ставшие Богами : Рационально - критическое богословие » . The etude that mentions LCF is based on the Prologue and Epilogue of the essay: Архипов СВ. Дети человеческие: истоки библейских преданий в обозрении врача . Йоэнсуу: Издание Автора, 2025. [Arkhipov SV. Human Children: The Origins of Biblical Legends from a Physician's Perspective]. Physician s Who Became Gods: Rational-Critical Theology By Sergey V. Arkhipov CONTENT The Prolegomena The Scene The play “ Immanuel ” The Divertissement The Prelude The Creation and Birth The Ministry and Teaching The Coda The Reflections a fter Word and Sound Application The Prolegomena Is it ethical to offer children, the sick, and the less educated a literal or supernatural interpretation of Genesis and the Gospels when a reasonable explanation exists? I propose a rational, interdisciplinary reading of the Scriptures from the perspective...

2024StetzelbergerVM_TannastM

Content [i] Summary [ii] Annotation [iii] Illustrations and References [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Summary Abstract of the article Stetzelberger VM, Nishimura H, Hollenbeck JF, Garcia A, Brown JR, Schwab JM, Philippon JM, Tannast M (2024). The authors found low ligamentum capitis femoris (LCF) strength in patients with femoroacetabular impingement. A Russian translation is available at this link: 2024StetzelbergerVM_TannastM . [ii] Annotation Background: Intraarticular hip pain represents a substantial clinical challenge, with recent studies implicating lesions in the ligamentum teres as potential contributors. Even more so, damage to the ligamentum teres is particularly prevalent among young patients undergoing joint-preserving interventions. Although several studies have investigated the biomechanical attributes of the ligamentum teres,...

1848HarrisonR

Content [i] Annotation [ii] Original text [iii] Illustrations [iv] Source & links [v] Notes [vi] Authors & Affiliations [vii] Keywords [i] Annotation Fragments from the book: Harrison R. Textbook of Practical Anatomy (1848). The author discusses the anatomy, topography, and role of the ligamentum capitis femoris (LCF), noting its length as 1.5 inches, or approximately 38 mm. The text in Russian is available at the following link: 1848HarrisonR . [ii] Original text Quote pp. 654-655. Mr. Flood (Lancet, 1829-30, page 672) has described an intarticular ligament, which, he says, "may be easily exposed by cutting through the inferior part of the capsule transversely, and throwing back the arm over the head. You thus expose the interior of the upper part of the capsule, also the biceps tendon. Parallel to the inner edge of the latter this ligament may be felt, and exposed by a lit...

Search This Blog