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

LCF in 2025 (November)

LCF in 2025 ( November ) (Quotes from articles and books published in October 2025 mentioning the ligamentum capitis femoris) Awad, A., Rizk, A., ElAlfy, M., Hamed, M., Abdelghany, A. M., Mosbah, E., ... & Karrouf, G. (2025). Synergistic Effects of Hydroxyapatite Nanoparticles and Platelet Rich Fibrin on Femoral Head Avascular Necrosis Repair in a Rat Model. Journal of Biomedical Materials Research Part B: Applied Biomaterials , 113 (11), e35672. [i] onlinelibrary.wiley.com Loughzail, M. R., Aguenaou, O., Fekhaoui, M. R., Mekkaoui, J., Bassir, R. A., Boufettal, M., ... & Lamrani, M. O. (2025). Posterior Fracture–Dislocation of the Femoral Head: A Case Report and Review of the Literature. Sch J Med Case Rep , 10 , 2483-2486. [ii] saspublishers.com , saspublishers.com Vertesich, K., Noebauer-Huhmann, I. M., Schreiner, M., Schneider, E., Willegger,...

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...

1996(r)ArkhipovSV

METHOD OF PELVIS OSTEOTOMY (Способ остеотомии таза) Patent Application RU96120699A Inventor Сергей Васильевич Архипов Original Assignee Sergey Vasilyevich Arkhipov Application RU96120699/14A events 1996-10-01 Application filed by С . В . Архипов 1999-01-20 Publication of RU96120699A Claims The method of pelvic osteotomy by complete intersection of the ilium above the capsule and acetabulum, characterized in that after arthrotomy of the hip joint the hip bones additionally intersect in front and behind the acetabulum, as well as above it between the capsule and limb, with the displacement of the formed intermediate fragment laterally and osteosynthesis fragments, in addition, plastic or prosthetics of the ligament of the femoral head can be performed, and an osteograft can be fixed over the intermediate fragment. Description of the invention Description in Russian is available at the link: 1996(r) АрхиповСВ (the blog has a translation function)....

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 ] ...

Human Children. Retelling of Chapter 15

Short retelling of chapter 15 of the essay: Arkhipov S.V. Human Children: The Origins of Biblical Legends from a Physician's Perspective. Joensuu: Author's Edition, 2025. [In Russian] Chapter 15. EXODUS FROM HARAN Jacob thrives as a shepherd in Haran, amassing wealth while his father-in-law, Laban, grows poorer. Sensing Laban’s growing resentment, Jacob foresees trouble and flees with his family, livestock, and possessions, aiming for “the land of Canaan.” His caravan crosses a river—likely the Euphrates—and heads toward “Mount Gilead.” Genesis doesn’t specify the journey’s duration, but ten days later, Laban overtakes Jacob at Gilead. Here, it’s revealed Jacob labored 20 years in Haran: 14 for his wives, Leah and Rachel, and six under a later deal for livestock. At Mount Gilead, the families reconcile, sealing peace with a monument—a rock pillar encircled by stones—named “Jegar-Sahadutha,” “Galeed,” and “Mizpah.” Laban returns home, and Jacob presses on to “Mahanaim.” ...

2007ArkhipovSV_ArkhipovaLN

METHOD OF ARTHROSCOPY OF HIP JOINT ( Способ артроскопии тазобедренного сустава ) Patent Application RU2007103463A Inventor Сергей Васильевич Архипов Людмила Николаевна Архипова Original Assignee Sergey Vasilyevich Arkhipov Ludmila Nikolaevna Arkhipova Application RU2007103463/14A events 2007-01-29 Application filed by Сергей Васильевич Архипов (RU), Людмила Николаевна Архипова (RU) 2007-01-29 Priority to RU2007103463/14A 2008-08-10 Publication of RU2007103463A Claims A method for arthroscopy of a hip joint by introducing an optical system and instruments into its acetabular part, characterized in that they are inserted from lateral access through one or more through channels made in the femur in the direction from its outer side to the femoral head, and during examination the acetabular part of the joint, the patient turns so that this hip joint is below the opposite. Description of the invention Description in Russian is available ...

1996(p)ArkhipovSV

METHOD FOR TRANSPOSITION OF THE ACETABULUM (Способ транспозиции вертлужной впадины) Patent Application RU96120311A Inventor Сергей Васильевич Архипов Original Assignee Sergey Vasilyevich Arkhipov Application RU96120311/14A events 1996-10-09 Application filed by С . В . Архипов 1999-01-20 Publication of RU96120311A Claims A method for transposition of the acetabulum by dissecting the iliac, pubic and sciatic bones of the pelvis around the circumference of the acetabulum, characterized in that after arthrotomy of the hip joint, the dissection of the pelvic bones is performed between the capsule and limb, and the resulting fragment is displaced medially and fixed; in addition, plastic or prosthetics of the ligament of the femoral head. Description of the invention Description in Russian is available at the link: 1996(p) АрхиповСВ (the blog has a translation function). External links: Arkhipov SV. Method for transposition of the acet...

1543(b)VesaliusA

Fragment from the book Vesalius A. Humani corporis fabrica librorum Epitome (1543). The author describes the attachment and shape of the ligamentum capitis femoris (LCF). Our brief commentary is available at the link: 1543(b)VesaliusA [Rus]. Quote. [Lat] Caput. II. De ossium ac cartilaginvm ligamentis, et musculis arbitrarij motus instrumentis Ex femoris superiori capite teres ligamentum in coxendicis acetabulum insertur. Translation [Eng] Quote. Chapter II. On the ligaments of the bones, cartilages, and muscles that perform voluntary movements. From the upper head of the femur, the round ligament is inserted into the acetabulum of the hip joint. Jan Stephan van Calcar (ca. 1543) External links Vesalius A. Humani corporis fabrica librorum Epitome. Basileae: Ex officina Joannis Oporini, Anno MDXLIII Mense Iunio [June, 1543]. [ books.google ] Authors & Affiliations Andreas Vesalius (And ries van Wezel, 1514-1564) physician, anatomist, professor at the Univers...

1841StanleyE

The article primarily discusses pathological hip dislocations and mentions pathology of the ligamentum capitis femoris (LCF). In particular, the author personally observed elongation of the LCF in hemiplegia. Analyzing one of the observations, Edward Stanley suggested the idea of primary LCF injury as the cause of subsequent dislocation. Discussing the variable morphology of this structure, the author lists witnesses of the absence of LCF ( Palletta , Bonn , Sandifort , Kaldani) and its elongation (M. Vrolik from Amsterdam). ON DISLOCATIONS, ESPECIALLY OF THE HIP-JOINT, ACCOMPANIED BY ELONGATION OF THE CAPSULE AND LIGAMENTS. By EDWARD STANLEY, F.R.S., SURGEON TO ST. BARTHOLOMEW'S HOSPITAL. READ JANUARY 12TH, 1841. It may be presumed that observations similar to those which I am about to submit to the Society, have occurred to other pathologists and surgeons; yet as the subject of dislocations of the larger joints, and especially of the hip, occurring ...

1720RuyschF

The author draws attention to the well-developed blood supply of the acetabular fossa, as well as the ligamentum capitis femoris (LCF). In the work, it is referred to as the «ligamentum nerveo-cartilagineum», which literally means the tough cartilaginous ligament and implies its strength. With the difficulty of accessing the acetabular fossa, and therefore the LCF, Frederik Ruysch associates the inefficiency of treating hip joint pain. The writer presumably implies osteoarthritis. In our opinion, its development is initiated by the pathology of the LCF ( 2012АрхиповСВ ). The discussed work includes a black and white drawing of the LCF of a child, made by the illustrator Jan Wandelaar. In color, the same preparation, but from a different angle, was depicted by the artist Jan l'Admiral in a separate publication ( 1738LadmiralJ ). Ruysch F. Adversarium anatomico-medico-chirurgicorum decas secunda. In quâ varia notatu digna recensentur. Cum figuris aeneis. Amsterdami: a...

Search This Blog