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, M., Böhler, C., ... & Chiari, C. (2025). The position of the femoral fovea can indicate hip instability and highly correlates with lesions of the ligamentum teres: an observational study. BMC Musculoskeletal Disorders, 26(1), 1028. [iii] link.springer.com
Kolachala, A. C. S., Ghosh, A. K., Khatri, J. P., Rangasamy, K., Gopinathan, N. R., & Sudesh, P. (2025). Ligamentum Teres Avulsion Fracture and Posterior Labral Tear After a Pediatric Hip Dislocation: A Case Report. JBJS Case Connector, 15(4), e25. [iv] journals.lww.com
Deng, L., Zhang, W., Fang, X., Liu, C., Li, P., Xie, Z., ... & Wang, X. (2025). The intertrochanteric line approach for irreducible femoral neck fractures: a novel open reduction technique with favorable clinical outcomes. European Journal of Medical Research, 30(1), 1085. [v] link.springer.com
Delcourt, R., Grillo, O. N., Hendrickx, C., Kellermann, M., & Langer, M. C. (2025). The coelurosaur theropods of the Romualdo formation, early Cretaceous (Aptian) of Brazil: Santanaraptor placidus meets Mirischia asymmetrica. The Anatomical Record. 18 November 2025 https://doi.org/10.1002/ar.70085 [vi] anatomypubs.onlinelibrary.wiley.com
Gornitzky, A. L., Zaltz, I., Hartwell, M. J., Bedi, A., & Kelly, B. T. (2026). The Layer+ Model: Incorporating Psychosocial Considerations into Hip Preservation Surgery. Current Reviews in Musculoskeletal Medicine, 19(1), 5. [vii] link.springer.com
Ito, H., Tanaka, S., Feng, Y., Nabae, H., Harada, Y., Fukuhara, A., & Suzumori, K. (2025). A Canine Musculoskeletal Robot for Investigating Biomechanical Functions During Locomotion. Advanced Robotics Research, e202500170. [viii] advanced.onlinelibrary.wiley.com
Chen, J., Zhang, Y., Feng, Z., Cai, L., Huang, S., Liu, Z., & Liu, W. (2025). Femoral head fracture management: outcomes of surgical hip dislocation with bioabsorbable screw fixation. Journal of Orthopaedic Surgery and Research, 20(1), 1029. [ix] link.springer.com
Arkhipov, SV. Arkhipova, LN. (2025). Who, When, and Where Wrote the Book of Genesis? A Medical Hypothesis. About round ligament of femur. [x] academia.edu
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[i] The articular capsule was then transected, the femoral head was dislocated from the acetabulum, and then the Ligamentum Teres was cut.
[ii] a right posterior fracture-dislocation of the femoral head (Pipkin Type II) following a road traffic accident.
Closed reduction under general anesthesia,attempted three hours post-injury, was unsuccessful. Thepatient subsequently underwent open reduction via aposterior Moore approach. Intraoperative findingsincluded partial tearing of the short external rotators, animpaction of the femoral head against the posterioracetabular rim, and a posteriorly displaced cephalicfragment attached to the ligamentum teres (Figure 4).
[iii] Abstract
Methods
Data was retrospectively analysed from a single centre database for hip preservations surgery. All patients underwent a comprehensive and standardized radiographic and clinical assessments. Sixty patients, with a mean age of 29.7 years (Standard Deviation [SD] 8.02), with 63 hips (40 right [63.5%] and 23 left [36.5%]) were included. Inter-observer reliability using the intraclass correlation coefficient (ICC) method, Pearson Correlation Coefficient, and further Analysis of Variance (ANOVA) and Multivariate Analysis of Variance (MANOVA) with post hoc Bonferroni correction were performed.
Inter-observer reliability assessed by ICC showed excellent reliability for all radiographic parameters. DA, as well as the Femoro-Epiphyseal Acetabular Roof (FEAR) index and (Gothic Arch Angle) GAA, showed strong correlation with Lateral Centre Edge Angle (LCEA) values. LT tears were highly linked to the presence of hip instability, showing significant differences in each model when analysing DA as well as the FEAR index and GAA (p < .001), MANOVA of microinstability parameters combined with clinical tests showed significant correlation (p < .001) with the Hyperextension-External Rotation (HEER) test. Other functional tests did not show significant correlation.
The DA can be reliably measured and can serve as a valuable supportive parameter in the assessment of hip microinstability. Radiographic instability parameters showed significant correlation with LT tears, suggesting they may function as useful additional markers for this specific lesion. Additionally, a positive HEER test was associated with the presence of microinstability parameters and may therefore be included in the clinical evaluation of these patients.
[iv] Abstract
[v] Some scholars hold that repeated rotation or pulling of the affected limb during closed reduction will inevitably aggravate vasospasm and distortion of the arteries in the round ligaments of the femur, may lead to vascular embolism, and then destroy the blood supply to the femoral head [7].
Collinge CA, Mir H, McAndrew C. Displaced femoral neck fracture in young adults: accessory fixation with buttress plating. Tech Orthop. 2015;30:16–21. https://doi.org/10.1097/bto.0000000000000131.
FIGURE 17 Santanaraptor placidus (MN 4802-V). Proximal (a–c) and distal (d–f) ends of the left femur in (a, c, e) caudal, (b) medial, (d) cranial, and (f) distal views. at, accessory trochanter; cmdc, craniomedial distal crest; crd, cranial depression; dd, distal depression; eg, extensor groove; faa, facies articularis antitrochanterica; fc, fibular condyle; fh, femoral head; fhl, femoral head lip; fm, foramen; gr, groove; gt, greater trochanter; lc, lateral condyle; lt, lesser trochanter; mc, medial condyle; ms, medial sulcus for the capitate ligament; pf, popliteal fossa; r, ridge; tfc, crista tibiofibularis. Scale bar equals 5 cm. (CC BY-NC-ND 4.0)
As for the medial margin, the articular facet forms a caudal loop, as it extends medially, surrounding a very deep, caudally positioned, sulcus (“ms” in Figures 12, 16, and 17) for the capitate ligament (= ligamentum capitis femoris). This is clearly seen in the left side of S. placidus (Figures 16 and 17), but also (contra Naish et al., 2004) in the medial portion of the right femoral head of M. asymmetrica (Figure 12). The head has a subsquared medial outline (Figure 17b), with flat proximal, cranial, and distal margins, and a pointed caudal margin that represents the maximal extension of the loop. The caudal surface is mostly excavated, with the distal margin of its medial expansion formed by a subtle ridge (“r” in Figure 17) that extends distally towards the shaft. The cranial surface of the head is divided into a striated proximolateral area and a smoother mediodistal emargination (“mde” in Figure 16).
[vii] As described by Draovitch and colleagues, the layer concept is a systemic means to determine which structures about the hip are the source of the pathology, which are the pain generators, and how you can use that information to best implement treatment [17]. Essentially, it’s a conceptual framework for all the inter-related mechanical and biological systems that clinicians can utilize in everyday practice to identify the most likely etiology of a patient’s symptoms. There are four layers (osseous, inert, contractile & neuromechanical), and each is made up of various anatomic structures which together serve a common purpose. For example, the inert layer includes the capsule, labrum, ligamentous teres and ligamentous complexes which together provide static stability, while the contractile layer includes the musculature crossing the hip, the lumbosacral muscles and the pelvic floor which work together to provide dynamic stability. At its core, the Layer Model assumes that structure alone dictates treatment.
Draovitch P, Edelstein J, Kelly BT. The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment. Curr Rev Musculoskelet Med. 2012;5:1–8.
[viii] Biomimetics replicates biological functions and helps investigate mechanisms and movements. This study focuses on mimicking canine limb structures, particularly the flexible forelimb connection.
…
For nonmuscular components, we replicated tendons using highstrength synthetic fiber rope (Vectran ®, Kuraray) and ligaments using nitrile rubber cord. The simulated ligaments are enumerated in Table 3. In the limbs, the bones are connected only by these replicated tendons.
Imitated ligaments
Shoulder jointlateral and medial glenohumeral
ligaments transverse humeral retinaculum
Elbow joint
lateral and medial collateral ligament
oblique ligament, annular ligament
olecranon ligament
Carpal joint
lateral and medial collateral ligament
dorsal radiocarpal ligament
palmar ulnocarpal ligament
palmar radiocarpal ligament
radioulnar ligament
Hip joint
ligament of femoral head
sacrotuberous ligament
articular capsule
Knee joint
cranial cruciate ligament
meniscofemoral ligament
femoropatellar ligament
lateral and medial collateral ligament
Stifle joint
cranial tibiofibular ligament
lateral and medial collateral ligament
[ix] In 2001, Ganz [10] described the surgical hip dislocation approach, which provides 360° visualization of the femoral head, complete access to the acetabulum, and preservation of the ligamentum teres.
With continuous traction, the hip was flexed to 110°–120° to expose the anterolateral femoral head along the anterior acetabular rim. The femur was then externally rotated approximately 40°–60° while maintaining flexion. Subluxation was confirmed intraoperatively by palpation or fluoroscopy when the articular surface of the femoral head cleared the acetabular fossa and the posterior femoral neck contacted the posterior acetabular column. External rotation was then increased and the thigh slightly adducted to achieve full surgical dislocation (Fig. 1E), assisted by traction on the gluteus medius and minimus. The ligamentum teres was routinely transected to facilitate exposure; this step does not increase the risk of avascular necrosis [11].
After adequate exposure of the femoral head and acetabulum, a comminuted fracture was identified in the weight-bearing portion of the femoral head, involving the articular surface adjacent to the ligamentum teres, with articular surface impaction and cartilage injury.
Fig. 1 A Pre- and postoperative imaging of a Pipkin type I fracture; B pre- and postoperative imaging of a Pipkin type II fracture; C pre- and postoperative imaging of a Pipkin type III fracture; D pre- and postoperative imaging of a Pipkin type IV fracture; E intraoperative exposure of the femoral head in the “surgical dislocation” position; F removal of the femoral head fragment revealed a comminuted fracture in the weight-bearing region of the superior femoral head, with impaction of the local articular surface adjacent to the ligamentum teres and associated cartilage injury. The fracture comprised one large fragment and three smaller fragments; the smaller fragments were displaced posterior to the acetabulum, and the largest fragment remained within the acetabulum; G triangular fixation of the femoral head using absorbable screws; H postoperative recovery of hip joint function. (CC BY-NC-ND 4.0)
[x] How could the author of the Book of Genesis have known about the ligament of the head of femur before Greek physicians?
…
The physician-polymath demonstrated the breadth of his knowledge and depth of understanding of medico-social issues. We propose naming him Imhotep the Younger. Attributing a name to this talented physician facilitates crediting him with the earliest documentation of significant medical facts recorded in Genesis. One such fact is the earliest mention of the ligament of the head of femur and its injury as a cause of severe hip joint disease.
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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