LCF in 2025 (September)
(Quotes from articles and books published in September 2025 mentioning the ligamentum capitis femoris)
Zhang, Z., Dong, Q., Wang, T., You, H., & Wang, X. (2025). Redescription of the osteology and systematic of Panguraptor lufengensis (Neo-theropoda: Coelophysoidea). 01 September 2025. PREPRINT (Version 1) [i] researchsquare.com
Tripathy,
S. K., Khan, S., & Bhagat, A. (2025). Surgical Anatomy of the Femoral Head.
In A Practical Guide to Management of Femoral Head Fracture-Dislocation (pp. 1-13). Singapore: Springer Nature Singapore. [ii] link.springer.com
Yoon, B. H., Kim, H. S., Lim, Y. W., & Lim, S. J. (2025). Adhesive Capsulitis of the Hip: Clinical Features, Diagnosis, and Management. Hip & pelvis, 37(3), 171-177. [iii] pmc.ncbi.nlm.nih.gov
Bharath,
C. M., Aswath, C. A., Ayyadurai, P., Srinivasan, P., & Gavaskar, A. S.
(2025). Surgical Hip Dislocation Using a Trochanteric Flip Osteotomy. In A
Practical Guide to Management of Femoral Head Fracture-Dislocation (pp. 59-75). Singapore: Springer Nature Singapore. [iv]
link.springer.com
Kumar,
A., & Trikha, V. (2025). Femoral Head and Acetabular Fractures (Pipkin Type
IV Injuries). In A Practical Guide to Management of Femoral Head
Fracture-Dislocation (pp. 121-139). [v] Singapore: Springer Nature Singapore. link.springer.com
Gänsslen,
A., Graulich, T., Lindtner, R. A., Krappinger, D., & Lindahl, J. (2025).
Suprafoveal Fractures. In A Practical Guide to Management of Femoral Head
Fracture-Dislocation (pp. 91-106). Singapore: Springer Nature Singapore. [vi] link.springer.com
Sharma,
M., & Sen, R. K. (2025). Femoral Head and Neck Fracture. In A Practical
Guide to Management of Femoral Head Fracture-Dislocation (pp. 107-119). Singapore: Springer Nature
Singapore. [vii]
link.springer.com
Oklaz,
E. B., Ahmadov, A., Gurbuz, N., Sezgin, E. A., & Atalar, H. (2025). Hidden
blood loss in dega osteotomy with varus derotation osteotomy is more pronounced
than in varus derotation alone. Journal of Pediatric Orthopaedics B, 10-1097. [viii]
Chen,
J. H., Al’Khafaji, I., Ernstbrunner, L., O’Donnell, J., & Ackland, D.
(2025). Joint contact behavior in the native, ligamentum teres deficient and
surgically reconstructed hip: A biomechanics study on the anatomically normal
hip. Clinical Biomechanics, 106666. [ix] clinbiomech.com
,
sciencedirect.com
Silva,
M. V. S., Serafim, B. L. C., de Angeli, L. R. A., & Zuccon, A. (2025).
Surgical treatment of hip dysplasia in cerebral palsy: A retrospective
comparison between open and closed reduction. Medicine, 104(36), e44245. [x]
journals.lww.com
Teng,
J., Zhang, S., Li, J., Li, B., Ren, L., Wang, K., ... & Ren, L. (2025).
Artificial Hip Joint Round Ligament with High Fidelity to Human Structures and
Mechanics via Bioinspired 3D Braided Fibers. Journal of Bionic Engineering, 1-13. [xi]
link.springer.com
Kale,
D., Kale, S., Pratheep, S., Modak, A., Bharamgunde, R., & Kale, S. (2025).
Extraarticular Interfragmentary Fixation of an Irreducible Pipkin Type 1
Fracture Dislocation of the Hip–A Case Report. Journal of Orthopaedic Case
Reports, 15(9), 194-198. [xii]
pmc.ncbi.nlm.nih.gov
Yang,
G., Huang, S., Liu, D., Yuan, Y., Yu, Y., Li, Y., ... & Zhao, Z. (2025).
Early postoperative three-phase Technetium-99 m bone scanning predicts
traumatic osteonecrosis in patients with femoral neck fractures: a 2-to 6-year
follow-up study. Archives of Orthopaedic and Trauma Surgery, 145(1), 1-8.
[xiii]
VIDYESH,
M. S. (2025). EVALUATION OF TOGGLE PINNING TECHNIQUE FOR SURGICAL MANAGEMENT
OF COXOFEMORAL DISLOCATION IN DOG (Doctoral dissertation, MAHARASHTRA ANIMAL
AND FISHERY SCIENCES UNIVERSITY). [xiv] krishikosh.egranth.ac.in
Baek,
N. J., Park, S., Lee, S., Kim, D. H., Kim, H. J., Chang, J. S., & Yoon, P.
W. (2025). Reliability of MRI-based grading using Yoon’s classification for
labral tears in hip dysplasia. Journal of Hip Preservation Surgery, hnaf058. [xv] academic.oup.com
Donati,
D., Tedeschi, R., Garnum, P. E., Vita, F., Tarallo, L., Faldini, C., &
Catani, F. (2025). A narrative review on greater trochanteric pain syndrome:
diagnostic imaging and non-surgical treatments. Musculoskeletal surgery, 1-10. [xvi] link.springer.com
Zhang,
T., Yang, J., & Yu, S. (2025). Secreted Frizzled‐Related Protein 2 Promotes
Osteogenic Differentiation and Bone Regeneration in Perthes Disease When
Targeted by miR‐106a‐5p. Journal of Cellular and Molecular Medicine, 29(18), e70804. [xvii] pmc.ncbi.nlm.nih.gov
Pür, B., Yılar, S., Dağ, İ., Kaşali, K., Uzun, A. A., Şenocak, E., & Demir, M. (2025). Comparative evaluation of long-term spinopelvic morphology after salter and pemberton osteotomies in DDH patients: follow-up of 8 years. BMC Musculoskeletal Disorders, 26(1), 860. [xviii] bmcmusculoskeletdisord.biomedcentral.com
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[i] The edge of the proximal side of femur is
circular in shape and rounded, with well-developed ligament fossa. Posterior to
the ligament fossa is a distinct dorsolateral trochanter. … Distally from the
ligament fossa, on the lateral surface of femur, both the anterior trochanter
(=lesser trochanter in some research, e.g. Raath 1977).
Raath, M. (1977). The Anatomy of the Triassic Theropod Syntarsus rhodesiensis (Saurischia: Podokesauridae) and a Consideration of Its Biology. Department of Zoology and Entomology, Rhodes University, Salisbury, Rhodesia. 1–233.
[ii] This depression provides attachment to
the ligament of the head of the femur (ligamentum capitis femoris) that connects
the head of the femur
[iii] Furthermore, the presence of contrast
filling around the ligamentum teres and extracapsular contrast leakage was more
common in the ACH [adhesive capsulitis of the hip] group.
[iv] Fractured head fragments, especially
type I (infra-foveolar) fragments, are often attached to the ligamentum teres and are retained in the acetabular cavity after
dislocation. The fragment may have to be detached from the ligamentum teres …
[v] Femur-Head Fracture: Fracture through the femur-head, usually
in the region of the fovea (where ligament teres is attached), seen on anteroposterior (AP) and
lateral hip radiographs as loss of femur-head sphericity.
[vi] Simultaneously, medially directed shear
forces act on the femoral head, causing a suprafoveal fracture
consistent with Pipkin type II, often with the fragment retained within
the joint due to an intact ligamentum teres.
[vii] The antegrade blood supply is provided
by the foveal artery (or artery of ligamentum teres), which is a branch of the obturator artery.
[viii] Arthrotomy was routinely performed in
all cases to remove the pulvinar tissue and ligamentum teres.
Background
The ligamentum teres contributes
to hip joint stability, yet the effect of surgical reconstruction of ligamentum
teres tears on hip joint function is poorly understood. This study aimed to
employ a cadaver model to quantify peak pressure, average pressure, contact
force, and contact area between the femoral head and acetabulum in native,
ligamentum teres deficient and reconstructed hips.
Methods
Nine fresh-frozen human cadaveric
hips were dissected and mounted to a multi-axis Materials Test System. Digital
pressure sensors were placed on anterior, posterior, and superior regions of
the acetabulum. Joint loading was simulated in flexion, neutral position, and extension.
Peak pressure, average pressure, contact force, and contact area were measured.
Findings
Ligamentum teres deficiency
caused a significant increase in average pressure (mean difference: 161.6 kPa, p = 0.002)
in the superior acetabulum in the neutral hip relative to the intact hip and in
peak pressure (mean difference: 1462.5 kPa, p = 0.023) in the anterior
acetabulum in the extended hip compared to the intact hip. Ligamentum teres
reconstruction subsequently restored average and peak pressure to levels not
significantly different from the intact state (p > 0.05).
Reconstruction also led to a significant decrease in average pressure (mean
difference 241.0 kPa, p = 0.047) and contact force (mean
difference: 124.5 N, p = 0.039) in the posterior acetabulum in the
flexed hip relative to the intact hip.
Interpretation
Ligamentum teres reconstruction
may help to prevent excessive contact that occurs in the ligamentum teres
deficient hip and may mitigate or slow the onset of degenerative changes
associated with ligamentum teres deficiency.
[x] The joint capsule is exposed and its
surface must be largely freed from the adjacent adipose tissue. The capsular
incision is made through a T-shaped incision. The ligamentum teres and the
pulvinar are resected if they are thickened, and the transverse acetabular
ligament is cut. After these obstacles are removed, we perform the VDRO [varus
derotation osteotomies] through a lateral incision in a standard
fashion.
[xi] Abstract
The rising prevalence of
hip joint disorders, particularly among aging populations, highlights the need
for advanced surgical and rehabilitation strategies. The artificial ligament
plays a key role in restoring joint stability in the treatment of hip joint disorders.
Existing commercial artificial ligaments differ from biological ligaments in
that they lack the complex hierarchical organization of natural ligaments. This
study introduces bioinspired hierarchical 3D braided ligaments to replicate the
nonlinear mechanical behavior of human ligaments. We examined the effects of
braiding strands and angles on the tensile properties of artificial ligaments,
including toe-region strain and linear modulus. Key characteristics such as
stress relaxation and fatigue were also assessed. Using FEA, we simulated fiber
interactions and macroscopic mechanical behavior, revealing the mechanisms
behind the J-shaped curve of braided ligaments. Based on theoretical analysis,
we selected a high-fidelity artificial braided ligament and compared the hip
joint’s range of motion with and without it. The results show that the
artificial hip with the round ligament closely mimics the human hip’s motion
(beyond 95% similarity in all directions including three translations and three
rotations), which reveals their potential to enhance joint stability and serve
as effective therapeutic and educational tools in medical practice.
[xii] Palpation of
the fragment, which was found lying inside the hip, revealed that the head was
rotated and attached to the ligamentum teres. It was derotated back to its
original position. On palpation, the fragment was very large and thus no
attempt to cut the ligamentum teres was done. The hip was reduced and
visualized under the image intensifier television (IITV) in the lateral
position.
[xiii] In contrast,
the preserved blood perfusion in the medial pillar [femoral head] may originate
from the inferior retinaculum artery or the ligamentum teres artery entering
the femoral head.
Surgical procedure for toggle
pinning
After exposing the hip joint,
the acetabulum was cleared of debris, haematoma, or fibrin. Exposure to
acetabular fossa was improved by outward rotation and adduction of the limb and
a hole was drilled in the acetabular fossa with a 3.5 mm diameter drill bit.
The toggle pin i.e. endobutton with suture strand looped through it was pushed
through the drilled hole to rest against the medial surface of the acetabulum,
within the pelvic cavity. The remnants of the detached round ligament were
cleared from the fovea capitis and a tunnel was created from the fovea capitis
to the greater trochanter using a 2.7mm drill bit. Using a guidewire, the
suture strands attached to the toggle pin was fed through the tunnel. After
reducing the joint, the ends of the suture strands were secured over the
lateral surface of the femur, just below the greater trochanter using a 2nd
titanium endobutton.
[xv] Acetabular labral tears are a common
source of pain, discomfort, and functional impairment in patients with hip
dysplasia, and may contribute to the development of hip osteoarthritis …
On MRI evaluation, paralabral
cysts were detected in 55.2% (n = 58) of hips, and arthroscopic evaluation
revealed partial LT tears in 78.1% (n = 82).
LT
tear (Arthroscopy)
No evidence of tear 22 (21.0%)
Partial tear 82 (78.1%)
Complete tear 1 (1.0%)
[xvi] Intra-articular
sources of hip pain include labral tears, loose bodies, femoroacetabular
impingement (FAI), capsular laxity, ligamentum teres rupture, and chondral
damage [27].
27. Redmond JM, Chen AW, Domb BG (2016) Greater trochanteric pain syndrome. J Am Acad Orthop Surg 24:231–240
[xvii] In summary, the rabbits were anaesthetised using intraperitoneal pentobarbital sodium. The rabbit model of Perthes disease was then produced by incising the ligamentum teres of the femoral head and ligating the femoral neck with an elastic non‐absorbable suture; this obstructed blood flow to the epiphysis. Ad‐SFRP2 (1 × 108 GC) and miR‐106a‐5p agomir (20 nmol) were injected into the femoral head 2 weeks after surgery (Figure S1); the same volumes of saline were used in the control and model groups. The rabbits were then euthanised at 8 weeks after surgery, and the femoral heads were harvested for subsequent experiments.
[xviii] All surgical
procedures were performed according to the original technique descriptions by
Salter and Pemberton. An anterior iliofemoral approach was used in all cases.
During surgery, the ligamentum teres was excised, the transverse acetabular
ligament was transected, and all intra-acetabular soft tissue obstacles were
removed to allow full reduction of the femoral head.
Author:
Arkhipov S.V. – candidate of medical sciences, surgeon, traumatologist-orthopedist.
Keywords
ligamentum capitis femoris, ligamentum teres, ligament of head of femur, history
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