Skip to main content

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

MiglioriniF., CocconiF., BardazziT., MasoniV., GardinoV., PipinoG., & MaffulliN. (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 Traumatology25, 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


Comments

Popular posts from this blog

13c.Soligalich

   Soligalich , icon, Jacob wrestling with the angel ( 13 cent. ).   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 wa s 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 ).     Soligalich  – Jacob Wrestling with the Angel ( 13 cent. ); original in the  leonovval...

Online Journal «ABOUT ROUND LIGAMENT OF FEMUR», March 2025

  The publication is dedicated to the ligamentum capitis femoris (LCF) and related topics.   About the Journal »»»                                                                                . The online journal  « About Round Ligament of  Femur »   was created based on the scientific blog of the same name. The resource is the English-language part of the project:  ONLINE JOURNAL:  Ligamentum capitis femoris . Updates:  As new materials are prepared. Mission :   Popularization and preservation of knowledge about LCF, as well as promoting its practical application. Main goal:  Improvement of diagnosis, treatment, and prevention of injuries and diseases of the hip joint. Publisher: Arkhipov S.V., independent researcher, PhD, ort...

LCF in 2026 (March)

  LCF in 2026 (March)  (Quotes from articles and books published in March 2026 mentioning the ligamentum capitis   femoris)       Kelly, J. J., Krych, A. J., & Hevesi, M. (2026). Arthroscopic Hip Capsular Reconstruction. Clinics in Sports Medicine . March 2, 2026. DOI: 10.1016/j.csm.2026.01.003   [i]   sportsmed.theclinics.com   Puga, T. B., Box, M. W., Perleberg, T., Paulter, B., O’Connor, K. P., & Riehl, J. T. (2026). Comparison of Intra‐Articular Hip Injections Using Ultrasound or Anatomic Landmarks: A Systematic Review and Meta‐Analysis. Advances in Orthopedics , 2026 (1), 5518632.   [ii]   onlinelibrary.wiley.com   Arkhipov, S. V. (2026). The Book of Bereshit as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution . About round ligament of f...

Variants and Phases of LCF Pathology

  Version : 20240418 Classification depending on the combination of factors leading to the pathology of ligamentum capitis femoris (LCF) VARIANTS OF LCF PATHOLOGY 1. Simple 2. Combined   We subdivide the phases of LCF pathology depending on the time elapsed after exposure. PHASES OF LCF PATHOLOGY 1. Acute 2. Subacute 3. Chronic 4. Permanent 5. Old Acute LCF pathology develops rapidly, sometimes instantaneously, as in the case of trauma. Chronic LCF pathology refers to a gradually progressing process that has started and persisted for a long time. The term subacute phase in LCF pathology is used when the process progresses and resolves within three weeks to four months. Permanent LCF pathology implies continuous periodic impact leading to pathological changes. An example of permanent pathology is walking with altered physical properties of the densely formed connective tissue comprising the LCF stroma. Old LCF pathology denotes a pathological change that...

1882ReevesHA

  Fragments from the book Reeves HA. Human Morphology: A Treatise on Practical and Applied Anatomy. Vol. 1. (1882). The author describes the anatomy of the ligamentum capitis femoris (LCF) and its role.   Quote pp. 451 - 452 By arrangement with the dissector of the abdomen, who will be interested in the observation, the student should carefully trephine or chisel out a small piece from the roof of the acetabulum in order to observe what has already been stated with regard to the capsule, and also to note how the ligamentum teres is affected with regard to its tension or laxity in the various movements of the joint. He may also try to inject into the joint some warm tallow so as to note if there be any hernial protrusions or projections of the synovial membrane between the layers of the capsule, or whether the synovial membrane of the joint communicates with any of the neighbouring bursæ, more especially with the psoas bursa. FIG 336. RIGHT HIP JOINT OPENED. The femur is pu...

Great Compilation. Chapter 25

      English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution.  Chapter 25   By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Book of Genesis. Chapter 25 Analysis [iii]   Notes to Chapter 25 [iv]   AI Agent's Conclusion [v]   Content [vi]   External links [vii]   Application [i]   Abstract The Book of Genesis (Beresh...

Great Compilation. Introduction

  English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution . Introduction By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Introduction [iii]   Content [iv]   External links [v]   Application [vi]   References [vii]   Application [i]   Abstract The Book of Genesis (Bereshith) was composed in Egypt during the 17th century BCE and reached ...

2021MeesonRL_StricklandR

The authors describe surgical stabilization of the femoral head in cases reluxation of traumatic hip dislocation in cats using the "Modified Knowles toggle" method, in which the ligamentum capitis femoris (LCF) is reconstructed from nylon or polydioxanone threads. Keywords ligamentum capitis femoris, ligamentum teres, ligament of head of femur, luxation, relaxation, hip, stabilization, reconstruction Original Article Meeson, R. L., & Strickland, R. (2021). Traumatic joint luxations in cats: Reduce, repair, replace, remove. Journal of feline medicine and surgery, 23(1), 17-32. doi.org/10.1177/1098612X20979508  [ scholar.google ] Authors & Affiliations Richard L Meeson MA, VetMB, PhD, MVetMed, DipECVS, FHEA, FRCVS, RCVS & ECVS Specialist Small Animal Surgery Rhiannon Strickland Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK .               ...

Great Compilation. Chapter 12

  English version of the article:  Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение.  О круглой связке бедра . 14.02.2026 .  The text in Russian is available at the following link:  2026АрхиповСВ .    The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution.  Chapter 12   By Sergey V. Arkhipov, MD, PhD   CONTENT [i]   Abstract [ii]   Book of Genesis. Chapter 12 Analysis [iii]   Notes to Chapter 12 [iv]   AI Agent's Conclusion [v]   Content [vi]   External links [vii]   Application [i]   Abstract The Book of Genesis (Bereshith) was compo...

1853JamainA

  Fragments from the book Jamain A. Nouveau traité élémentaire d'anatomie descriptive (1853). The author briefly describes the anatomy of the ligamentum capitis femoris (LCF), noting its three points of proximal attachment. The text is prepared for machine translation using a service built into the blog from Google or your web browser.   Quote p. 14 4 Surfaces articulaires. Du côté du fémur, tête hémisphérique encroûtée de cartilage et présentant à sa partie supérieure et interne une dépression qui loge un ligament inter-articulaire. Du côté de l'os iliaque , cavité cotyloïde, profonde , échancrée sur sa circonférence, surtout à sa partie antérieure et inférieure, et présentant dans sa partie profonde une dépression remplie de tissu adipeux rougeâtre, improprement appelé glande cotyloïdienne. Cette cavité est encroûtée de cartilage, excepté dans la dépression dont nous venons de parler. Quote p. 145 2. Ligamentinter-articulaire (fig. 12, 2, 3), appelé encore ligament r...