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

THE GIFTS OF THE MAGI FOR ORTHOPEDIC SURGEONS

  Translation of the article:   Архипов СВ. Новая техника проксимального крепления при реконструкции ligamentum capitis femoris: Дары волхвов ортопедическим хирургам. The text in Russian is available at the following link:  2026АрхиповСВ .  A Novel Technique for Proximal Fixation of Ligamentum Capitis Femoris Reconstruction: The Gifts of the Magi for Orthopedic Surgeons S.V. Arkhipov, Independent Researcher, Joensuu, Finland     CONTENT [i]   Abstract [ii]   Introduction [iii]   Materials and Methods [iv]   Technique [v]   Discussion [vi]   Conclusion [vii]   Appendix [viii]   References [ix]   Structured Abstract [x]   Additional material [i]   Abstract An experimental technique for reconstruction of the ligamentum capitis femoris (ligamentum teres femoris) is described. The proposed method involves creating two portions of the ligament analog: a pubic portion and an ischial portion. Fixation of thes...

2025SarassaC_HerreraAM

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article : Sarassa C. et al . I ntraosseous Tunneling and Ligamentum Teres Ligamentodesis “Teretization” to Enhance S tability in Congenital Hip Dislocation Surgery: Surgical Technique and Mid-Term Outcomes (2025). The article describes a technique for fixing the femoral head using the ligamentum capitis femoris (LCF) in congenital hip dislocation. The text in Russian is available at the following link: 2025SarassaC_HerreraAM . [ii]   Original text Abstract Background Developmental dysplasia of the hip (DDH) with complete dislocation (grade ≥III) in older patients often requires open reduction. However, achieving long-term stability remains challenging. This study introduces and evaluates a novel surgical technique, intraosseous tunneling ...

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...

Online Journal «ABOUT ROUND LIGAMENT OF FEMUR», January 2026

  The journal 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 researc...

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

  The journal 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 researc...

1970MichaelsG_MatlesAL

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article: Michaels G, Matles AL. The role of the ligamentum teres in congenital dislocation of the hip (1970). The authors proposed an analogy for the role of the ligamentum capitis femoris (LCF) as a “ball and chain control” and noted that it can spontaneously reduce congenital hip dislocation. The text in Russian is available at the following link: 1970MichaelsG_MatlesAL . [ii]   Original text Quote p. 199 Many papers in the literature have implicated the ligamentum teres as a hindrance to the late open reduction of a congenitally dislocated hip. Occasionally the ligamentum teres has been reported to be absent. However, in most cases it is hypertrophied and elongated. Our present knowledge confirms the fact that congenital dislocation of t...

BIOMECHANICS AND MORPHOMECHANICS

  BIOMECHANICS AND MORPHOMECHANICS   (On the rela tionship between the mechanics and morphology of the hip joint... )  1586PiccolominiA  One of the first discussions of the biomechanics of the LCF with a description of its shape, mechanical properties and attachment. 1728 WaltherAF   The selected excerpt discusses the anatomy, mechanical properties and function of the LCF. 1836WeberW_WeberE  Fragments from the book that laid the foundation of biomechanics of the hip joint considering th e LCF.  1836-1840PartridgeR  The author compared the LCF, in its function to a leathern  straps   by which the body of a carriage is suspended on springs . 1856MeyerGH  The author of the modern  theory of bio mechanics of the hip joint discusses  the significant role of the LCF during walking and maintaining an upright posture. 1857TurnerW  The fragment of the «Human Anatomy and Physiology» narrates the involvement of the LCF in distri...

2025EnglertG_KlingeleK

  Content [i]   Annotation [ii]   Original text [iii]   References [iv]   Source  &  links [v]   Notes [vi]   Authors & Affiliations [vii]   Keywords [i]   Annotation Abstract of the article: Englert G et al. Open Reduction With Ligamentum Teres Reconstruction—Preliminary Results of a Novel Technique for the Management of Pediatric Developmental Dysplasia of Hip). The article describes the ligamentum capitis femoris (LCF) reconstruction through the femoral tunnel for hip dysplasia. The text in Russian is available at the following link:  2025EnglertG_KlingeleK. [ii]   Original text Abstract Background:  The primary goal in the management of developmental dysplasia of the hip (DDH) is to obtain and maintain a stable, concentrically reduced hip via closed or open techniques while limiting iatrogenic risk. Recent studies suggest a 7% risk of recurrent instability following open reduction (OR) of idiopathic DDH an...

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

  The journal 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 researc...

2021PaezC_WengerDR

  Article: Paez C et al. Ligamentum teres transfer during medial open reduction in patients with developmental dysplasia of the hip (2021). The article analyzes the results of open reconstruction of ligamentum capitis femoris (LCF) in dysplasia. The text in Russian is available at the following link: 2021PaezC_WengerDR . Ligamentum teres transfer during medial open reduction in patients with developmental dysplasia of the hip   Paez C, Badrinath R, Holt J, Bomar JD, Mubarak SJ, Upasani VV, Wenger DR   CONTENT [i]   Abstract [ii]   Introduction [iii]   Materials and Methods [iv]   Results [v]   Discussion & Conclusion [vi]   References [vii]   Application [i]   Abstract Background The ligamentum teres (LT) is believed to have a number of functions, including a role in hip stability, nociception, proprioception, vascular supply to the femoral head, and synovial fluid circulation. The LT is often excised in the process of performin...