LCF in 2025 (October)
(Quotes from articles and books published in October 2025 mentioning the ligamentum capitis femoris)
Sen,
S., & Ray, S. (2025). Taxonomic reassessment of archosaurs with dinosaurian
affinities from the lower fauna of the Upper Triassic Maleri Formation of India
and their significance. Journal of Vertebrate Paleontology, e2546434. [i] tandfonline.com
Chitoglou,
K., Pandolfi, L., Konidaris, G. E., & Kostopoulos, D. S. (2025). Early
Pleistocene rhinoceroses (Mammalia, Perissodactyla, Rhinocerotidae) from
Northern Greece: biochronological and paleobiogeographic implications: K.
Chitoglou et al. PalZ, 1-28. [ii] link.springer.com
Chen,
Y., Li, J., Lin, J., Miao, Y., Yin, J., Li, G., & Zhang, C. (2025). Cystic
lesions in osteoarthritis and osteonecrosis of the femoral head: a comparative
analysis of 3D distribution, microstructure, and histology. Bone & Joint
Research, 14(10), 820-831. [iii] boneandjoint.org.uk
Venglar,
B. M. (2025). Physical Therapy Considerations in the Management of
Individuals With Non-Arthritic Sources of Hip and Shoulder Symptoms:
Examination Sequence, Treatment, and Potential Barriers to the Restoration of
Function (Doctoral dissertation, Oakland University). [iv] proquest.com
Ina,
J., Cabarcas, B., Kang, L., Okoroha, K. R., Levy, B. A., Krych, A. J., &
Hevesi, M. (2025). Intra-and periarticular hip anatomy through the arthroscope.
Journal of Cartilage & Joint Preservation, 100268.
[v]
sciencedirect.com
He,
M. C., Gu, B. N., Peng, P., Zhang, Q. W., Wei, Q. S., & He, W. (2025).
Autograft bone grafting via surgical hip dislocation for collapsed necrotic
femoral head: a mid-term retrospective study. BMC Musculoskeletal Disorders, 26(1), 943.
[vi]
link.springer.com
Teng,
J., Li, B., Zhao, X., Wang, K., Ren, L., Xie, H., ... & Ren, L. (2025).
Bioinspired 3D braided artificial ligament with human-like mechanical
properties and self-healing capability. Frontiers in Bioengineering and
Biotechnology, 13, 1701754. [vii]
frontiersin.org
Doering,
M., Garcia, M. S., Schiefelbein, J. H., Kerber, L., & Müller, R. T. (2025).
New tetrapod remains help constrain the age of a peculiar assemblage, including
early dinosaurs and pterosaur precursors, from the Upper Triassic of southern
Brazil. Journal
of Vertebrate Paleontology, e2552552. [viii] tandfonline.com
Elhence,
A., Yadav, S. K., Aggarwal, A., Singh, M., & Gavaskar, A. S. (2025). The
double floating extremity phenomenon: case studies and evidence-based
perspectives. European Journal of Orthopaedic Surgery & Traumatology, 35(1), 428. [ix]
link.springer.com
Robba,
T., Papa, F. P., De Iuliis, M., & La Paglia, E. (2025). Scoring systems for
osteoarthritis of the hip in radiology. Journal of Medical Imaging and Interventional
Radiology, 12(1), 37. [x] link.springer.com
Ramadanov, N., Voss, M., Heinz, M., Hable, R., Prill, R., Becker, R., & Banke, I. J. (2025). Capsular management strategies in hip arthroscopy for femoroacetabular impingement syndrome: A multilevel meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy. [xi] esskajournals.onlinelibrary.wiley.com
Uppstrom,
T. J., Khilnani, T. K., Trotzky, Z., Jochl, O., Spiker, A. M., Williams, R. J.,
... & Sink, E. L. (2025). Osteochondral Allograft Transplantation of the
Femoral Head via Surgical Hip Dislocation: Survivorship and Patient Reported
Outcome Measures at Minimum 2-Year Follow-Up. Orthopaedic Journal of Sports
Medicine, 13(10), 23259671251385115. [xii] journals.sagepub.com
Huang,
S., Cheng, X., Gao, S., Huang, X., Liu, Y., Feng, C., & Su, Y. (2025).
Femoral head vascular status in early-stage Legg–Calvé–Perthes disease assessed
by contrast-enhanced magnetic resonance imaging: comparison with the
contralateral side. Orphanet Journal of Rare Diseases, 20(1), 533.
[xiii]
link.springer.com
Bal,
Z., & Takakura, N. (2025, October). ELUCIDATING THE CHANGES IN VASCULAR
STRUCTURES IN A NOVEL SMALL ANIMAL TRAUMA MODEL FOR OSTEONECROSIS OF THE
FEMORAL HEAD. In Orthopaedic Proceedings (Vol. 107, No. SUPP_9, pp. 77-77). Bone &
Joint. [xiv]
Yönez,
M. K., Alpman, U., Aslan, N. E., Bahar, F. İ., & Alpman, E. (2025).
Measurement of the Norberg Angle Using Artificial Intelligence in Diagnosing
Canine Hip Dysplasia. Hip. [xv] pvj.com.pk
Thompson,
K., & Quinn, C. (2025). Epidemiology of Sports-related Injuries in Female
Athletes. Clinics in Sports Medicine. [xvi] sportsmed.theclinics.com
Saini,
J., Kaushik, N., Jain, P., Kumar, J., Singh, B., SAINI, J., ... & SINGH, B.
(2025). Recent Advances in the Diagnosis and Management of Pediatric Orthopedic
Disorders: A Comprehensive Review. Cureus, 17(10).
[xvii] assets.cureus.com
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
[i] Dinosaur Alwalkeria maleriensis … femoral head [has] sulcus for ligamentum captis femoris;
In posterior aspect, the proximal
femur bears a shallow sulcus for attachment of the ligament capitis femoris as in Staurikosaurus pricei …
[ii] Femur. In proximal view, the shape of the femoral head
of TSR-F18-56 (Fig. 12n, o) is rounded, and slightly transversally elongated. It
has a clear ligament fossa located at the posterior and medial part.
[iii] In the early
stages of OA, increased stress on the medial cartilage, potentially exacerbated
by factors such as injuries to the ligamentum teres, may contribute to cyst
development.51
51. Akiyama K , Sakai T , Koyanagi J , Yoshikawa H , Sugamoto K . Evaluation
of translation in the normal and dysplastic hip using three-dimensional
magnetic resonance imaging and voxel-based registration . Osteoarthritis
Cartilage . 2011 ; 19 ( 6 ): 700 – 710 .
[iv] Неартритная боль в тазобедренном суставе включала в себя диагнозы: FAI, дисплазия, разрывы суставной губы, хондральные поражения и разрывы круглой связки.
Fig. 1. Left hip specimen demonstrating the anterior and anterolateral hip capsule (dotted outline), which is, A, taught in hip extension, and subsequently, B, demonstrates relaxation of fibers (asterisk) with flexion, abduction, and external rotation. AIIS, anterior inferior iliac spine; ASIS, anterior superior iliac spine. (CC BY-NC-ND 4.0)
Fig. 3. A, Cadaveric dissection of a right hip demonstrating the
circumferential nature of the acetabular labrum, confluence of the anterior and
posterior labrum with the transverse acetabular ligament, and the iliopsoas-U
(asterisk). B, Subsequent intraoperative arthroscopic view of a right hip
demonstrating the acetabulum and iliopsoas-U, visualized at the anterior aspect
of the joint near the 3:00 position. View obtained from the anterolateral
portal. (CC BY-NC-ND 4.0)
Ligamentum teres
The ligamentum teres is a remnant of the artery of the ligamentum teres
present in the developing proximal femur that supplies the secondary
ossification center of the femoral head.29 The ligamentum teres is a tubular
structure that lies between the inferior aspect of the acetabulum and the fovea
of the femoral head (Fig. 5). On magnetic resonance imaging (MRI) evaluation,
the ligamentum has an overall length of 28 mm and is approximately 3- to 4-mm
thick and gradually tapers from proximal to distal.30 In adulthood, this
structure continues to function as a secondary stabilizer of the hip that
tightens during hip abduction, internal rotation, and external rotation and may
prevent microinstability of the hip joint.31, 32 In addition to its function as
a secondary stabilizer, it has been proposed that the ligamentum teres
continues to have a role in femoral head proprioception and nociception.33
Injury to the ligamentum teres can occur secondary to trauma, degeneration, or
impingement and can be seen as complete tears, partial tears, or degenerative
changes that result in pain and microinstability. A retrospective study by
Perumal et al reported identification of a ligamentum teres lesion on hip
arthroscopy resulted in poorer patient-reported outcomes as well as an
increased likelihood of conversion to total hip arthroplasty within 2 years,
highlighting the potential biomechanical importance of the ligamentum in hip
function.34
29. S.M. Chung. The arterial supply of the developing proximal end of the human femur J Bone Jt Surg Am, 58 (7) (1976), pp. 961-970
30. D.G. Blankenbaker, A.A. De Smet, J.S. Keene, A.M. del Rio. Imaging
appearance of the normal and partially torn ligamentum teres on hip MR
arthrography. Am J Roentgenol, 199 (5) (2012), pp. 1093-1098, 10.2214/AJR.12.8630
31. R.L. Martin, B.R. Kivlan, F.R. Clemente. A cadaveric model for
ligamentum teres function: a pilot study. Knee Surg Sports Traumatol Arthrosc,
21 (7) (2013), pp. 1689-1693, 10.1007/s00167-012-2262-5
32. J.Y. Wu, W. Li, L.Y. Xu, G. Zheng, X.D. Chen, C. Shen. Ligamentum
teres tears and increased combined anteversion are associated with hip
microinstability in patients with borderline dysplasia. Arthroscopy, 40 (3)
(2024), pp. 745-751, 10.1016/j.arthro.2023.06.041
33. L. Cerezal, A. Kassarjian, A. Canga, et al. Anatomy, biomechanics,
imaging, and management of ligamentum teres injuries. RadioGraphics, 30 (6)
(2010), pp. 1637-1651, 10.1148/rg.306105516
34. V. Perumal, S.J. Woodley, H.D. Nicholson, M.J. Brick, C.J. Bacon. Ligamentum teres lesions are associated with poorer patient outcomes in a large primary hip arthroscopy cohort of 1,935 patients. Arthrosc Sports Med Rehabil, 4 (4) (2022), pp. e1363-e1372, 10.1016/j.asmr.2022.04.024
Fig. 5. A, Cadaveric dissection of a right hip demonstrating the
ligamentum teres (black asterisk) as it connects the inferior aspect of the
acetabulum and the femoral head fovea. B, Arthroscopic intra-articular view
from the anterolateral portal demonstrating an intact ligamentum teres (white
asterisk). (CC BY-NC-ND 4.0)
Fig. 7. A, Fluoroscopic arthrogram outlining both the medial (dashed
arrow) and lateral (solid arrow) retinacular folds and vessels. B,
Intra-articular view of a right hip from the modified anterior portal
demonstrating the lateral retinacular vessels (white asterisk) as they pass
from distal to proximal adjacent to the zona orbicularis. (CC BY-NC-ND 4.0)
Fig. 9. Native communication between the hip and iliopsoas bursa, as demonstrated on a, A, fluoroscopically guided arthrogram and, B, subsequently on axial T2-weighted magnetic resonance imaging. White arrow denotes area of communication in anterior hip capsule. (CC BY-NC-ND 4.0)
[vi] The joint capsule was incised by the
shape of “Z”, and round ligament was cut to make the femoral head dislocate
forward (Fig. 1C). … After washing the joint cavity, the affected hip was reduced by
traction and the joint capsule was sutured.
Figure 1. Self-healing ligament. (a) The hierarchical architecture of natural ligaments. (b) The hybrid artificial ligament integrating SMA wires and polyethylene fishing line. (c) The DSC measurements of the SMA material. (d) DMA characterization of the SMA material. Uniaxial tensile hysteresis testing of the (e) fish line and (f) SMA materials.
[viii] Upper
Triassic… There is also no distinct
longitudinal sulcus in the proximal surface of the femoral head.
[ix] The vascular supply of the femoral head
is primarily derived from the medial femoral circumflex artery through the
posterior retinacular branches, with minor contributions from the lateral
femoral circumflex system and the artery of ligamentum teres [22, 23]
[x] Lastly, abnormalities of the ligamentum
teres are graded from 0 (normal) to 3 (complete tear), with intermediate
categories for signal abnormality or fraying (1) and partial tear (2).
[xi] Hip
arthroscopy (HAS) often requires capsular management to access and treat
labral, ligamentum teres, acetabular rim, or femoral head–neck pathology.
[xii] The surgical hip dislocation (SHD), in
its current technique utilizing a trochanteric flip osteotomy, was first
described by Ganz in 2001.11
This procedure offers full access to the hip and
allows the surgeon to both address cartilage lesions and other concomitant
intra-articular pathology—including cam-type femoroacetabular impingement (FAI)
or pincer lesions, labral tears, loose bodies, et cetera. However, this
procedure requires disruption of the ligamentum teres. It may result in
microtrauma to the labrum or compromise of the vascular supply, with the
potential for AVN or microinstability, although further research is required.
[xiii] In
angiographic studies, Atsumi et al. also showed that the ligamentum teres
artery plays an important role in blood supply reconstruction in patients with
LCPD (Legg–Calvé–Perthes disease)
[17]. Morris et al. reported on the medial and lateral perfusion in patients
with LCPD using perfusion MRI [18].
The cartilaginous vessels in the posterior and anterior parts were
significantly fewer than those in the lateral and medial parts. Increases in
the vessels anterior to the FH (femoral
head) are rare. This could be because these two parts are farther
away from the main blood supply ranges of the LEA (lateral epiphyseal artery) and ligamentum teres
artery.
17. Atsumi T, Yoshihara S, Hiranuma Y. Revascularization of the artery
of the ligamentum teres in Perthes disease. Clin Orthop Relat Res.
2001;386210–7. doi.org 10.1097/00003086-200105000-00027.
18. Morris WZ, Valencia AA, McGuire MF, Kim H. The role of the artery of
ligamentum Teres in revascularization in Legg-Calve-Perthes disease. J Pediatr
Orthop. 2022;42(4):175–8. doi.org
10.1097/BPO.0000000000002061.
[xiv] Left femoral
head (FH) was dislocated from hip joint, ligamentum teres was cut in 8-week-old
male C57BL/6J mice to disrupt the blood supply to FH.
[xv] Cartilage
degeneration, thickening of the joint capsule, stretching or rupture of the
femoral head ligament, proliferation of the dorsal acetabular rim, thickening
of the femoral neck, and local muscle atrophy are characteristic features of
advanced hip dysplasia.
[xvi] Due to
hyperphysiologic mobility required of the hip joint, damage … [in] … dancers
include snapping syndromes of the hip, synovitis, and ligamentum teres
injuries.
[xvii] With
directvisualization [arthroscopic-assist], intra-articular obstructions,
including hypertrophied ligamentum teres, pulvinar tissue, or inverted labrum,
can be dealt with before reduction, obviating the necessity of widespread open
dissection.
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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