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
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