A Novel Technique for Proximal Fixation

Arkhipov SV. A Novel Technique for Proximal Fixation of Ligamentum Capitis Femoris Reconstruction: The Gifts of the Magi for Orthopedic Surgeons. About Round Ligament of Femur. January 14, 2026. DOI: 10.13140/RG.2.2.25269.33763

https://roundligament.blogspot.com/2026/01/the-gifts-of-magi-for-orthopedic.html

Abstract

Purpose: To describe an experimental technique for proximal fixation in ligamentum capitis femoris (ligamentum teres femoris; LCF) reconstruction using pubic and ischial portions anchored in corresponding pelvic bone tunnels, tested on synthetic hip joint models, and to propose it’s for arthroscopic application with visualization via an inferior portal and femoral tunnel.

Methods: Synthetic polyurethane bone analogs (Synbone) of the pelvis and proximal femur were used to fabricate hip joint models. Acetabular cartilage analogs were created from self-curing plastic compound. Femoral tunnels were drilled along the neck axis from the subtrochanteric region below the tuberculum innominatum to the femoral head fovea. Novel pubic and ischial tunnels were created from the pubic tubercle and superior to the ischial tuberosity, respectively, directed toward the bases of the anterior and posterior horns of the lunate surface, exiting at the acetabular notch. Braided nylon cords served as LCF analogs. Fixation and tensioning were demonstrated, with potential arthroscopic control through the acetabular notch via an inferior portal and femoral tunnel, avoiding distraction where possible. Mechanical stability was assessed qualitatively on models.

Results: The proposed dual-bundle (pubic and ischial) proximal fixation replicated natural LCF anatomy and provided satisfactory limitation of adduction and rotational motions in the model. Femoral tunnel placement preserved vascular anatomy. Pelvic tunnels avoided intrapelvic neurovascular structures and organs. Visualization and instrumentation via the inferior portal, femoral and pelvic tunnels allow for joint inspection, debridement and graft insertion without distraction. Tensioning of LCF analog was adjustable in adduction, extension, and external rotation. Integration with implants for osteosynthesis or future endoprostheses was conceptually demonstrated.

Conclusions: This experimental technique offers a novel, potentially more reliable proximal fixation for LCF reconstruction by distributing load across pubic and ischial tunnels, addressing limitations of traditional acetabular fossa fixation (thin bone, neurovascular risk). Arthroscopic feasibility relies on the inferior portal and femoral tunnel for visualization and manipulation. While promising for stability and reduced complications in models, clinical validation is required. The method may represent an advancement in managing LCF pathology, particularly in instability.

Level of Evidence: Level V, technique description, model study.

Keywords: hip joint, reconstruction, ligamentum capitis femoris, ligamentum teres, fixation, arthroscopy, technique, experiment

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13c.Soligalich

Soligalich , icon, Jacob wrestling with the angel ( 13 cent. ). Depicting the circumstances and mechanism of the ligamentum capitis femoris (LCF) injury based on the description in the Book of Genesis: 25 And Ja cob wa s left alone; and there wrestled a man with him until the breaking of the day. 26 And when he saw that he could not pre vail against him, he struck against the hollow of his thigh ; and the hollow of Jacob's thigh was put out of joint, as he was wrestling with him. … 33 Therefore do the children of Israel not eat the sinew which shrank, which is upon the hollow of the thigh, unto this day; because he struck against the hollow of Jacob's thigh on the sinew that shrank. ( 1922LeeserI , Genesis (Bereshit) 32:25-26,33) More about the plot in our work: Ninth month, eleventh day ( 2024 АрхиповСВ. Девятый месяц, одиннадцатый день ). Soligalich – Jacob Wrestling with the Angel ( 13 cent. ); original in the leonovval...

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SURGERY

SURGERY ( Osteotomy, arthroplasty, arthroscopy, ligamentoplasty... ) Inventions Method s by Arkhipov S.V. (subsection) Articles 1926HeyGrovesEH The author proposes fixation of the femoral head by creating a LCF from the joint capsule during reduction of congenital hip dislocation. 1927HeyGrovesEH The author describes fixation of the femoral head by creating a LCF from the joint capsule during reduction of congenital hip dislocation. 1968TrevorD The author discusses E. Hey Groves's operation for reconstruction of the LCF in the reduction of congenital hip dislocation. 2021ArkhipovSV_SkvortsovDV Ligamentum Teres and its Analog in the Hip Endoprosthesis–Necessary or Superfluous? A Systematic Review 2025ArkhipovSV. Why Acetabular Labrum Repair May Be Ineffective . Article (07.04.2025). UNDERWATER ROCK OF THE RECONSTRUCTIONS What is the load on the ligamentum capitis femoris ? The First...

1993ArkhipovSV

The publication describes the design of a total hip joint endoprosthesis, which became a prototype of an artificial hip joint with analogous to the ligamentum capitis femoris (LCF). Complete hip joint prosthesis designed by S.V. Arkhipova (Полный протез тазобедренного сустава конструкции С.В. Архипова ) Patent RU2089135 Inventor Sergey Vasilyevich Arkhipov Сергей Васильевич Архипов Original Assignee Sergey Vasilyevich Arkhipov Сергей Васильевич Архипов 1993-12-30 Application filed by Сергей Васильевич Архипов 1993-12-30 Priority to RU93057862A 1996-07-27 Publication of RU93057862A 1997-09-10 Application granted 1997-09-10 Publication of RU2089135C1 Abstract FIELD: medicine; prosthetics. SUBSTANCE: proposed complete prosthesis for hip joint comprises femoral component and acetabular components, both components being interconnected by pivot. Outer surface of acetabular component is provided with threads and grooves. Shank is made in form of collet chuck, tabs of whi...

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Version : 20240418 Classification depending on the combination of factors leading to the pathology of ligamentum capitis femoris (LCF) VARIANTS OF LCF PATHOLOGY 1. Simple 2. Combined We subdivide the phases of LCF pathology depending on the time elapsed after exposure. PHASES OF LCF PATHOLOGY 1. Acute 2. Subacute 3. Chronic 4. Permanent 5. Old Acute LCF pathology develops rapidly, sometimes instantaneously, as in the case of trauma. Chronic LCF pathology refers to a gradually progressing process that has started and persisted for a long time. The term subacute phase in LCF pathology is used when the process progresses and resolves within three weeks to four months. Permanent LCF pathology implies continuous periodic impact leading to pathological changes. An example of permanent pathology is walking with altered physical properties of the densely formed connective tissue comprising the LCF stroma. Old LCF pathology denotes a pathological change that...

2021MeesonRL_StricklandR

The authors describe surgical stabilization of the femoral head in cases reluxation of traumatic hip dislocation in cats using the "Modified Knowles toggle" method, in which the ligamentum capitis femoris (LCF) is reconstructed from nylon or polydioxanone threads. Keywords ligamentum capitis femoris, ligamentum teres, ligament of head of femur, luxation, relaxation, hip, stabilization, reconstruction Original Article Meeson, R. L., & Strickland, R. (2021). Traumatic joint luxations in cats: Reduce, repair, replace, remove. Journal of feline medicine and surgery, 23(1), 17-32. doi.org/10.1177/1098612X20979508 [ scholar.google ] Authors & Affiliations Richard L Meeson MA, VetMB, PhD, MVetMed, DipECVS, FHEA, FRCVS, RCVS & ECVS Specialist Small Animal Surgery Rhiannon Strickland Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK . ...

1853JamainA

Fragments from the book Jamain A. Nouveau traité élémentaire d'anatomie descriptive (1853). The author briefly describes the anatomy of the ligamentum capitis femoris (LCF), noting its three points of proximal attachment. The text is prepared for machine translation using a service built into the blog from Google or your web browser. Quote p. 14 4 Surfaces articulaires. Du côté du fémur, tête hémisphérique encroûtée de cartilage et présentant à sa partie supérieure et interne une dépression qui loge un ligament inter-articulaire. Du côté de l'os iliaque , cavité cotyloïde, profonde , échancrée sur sa circonférence, surtout à sa partie antérieure et inférieure, et présentant dans sa partie profonde une dépression remplie de tissu adipeux rougeâtre, improprement appelé glande cotyloïdienne. Cette cavité est encroûtée de cartilage, excepté dans la dépression dont nous venons de parler. Quote p. 145 2. Ligamentinter-articulaire (fig. 12, 2, 3), appelé encore ligament r...

1705PetitJL

Fragments from the book Petit JL. L'Art de Guérir les Maladies des Os (1705, first edition). The author writes about anatomy, role, and damage of the ligamentum capitis femoris (LCF) in hip dislocation. The text is prepared for machine translation using a service built into the blog from Google or your web browser. Quote 1. Ch. VII. p. 64. … outre que l'articulation du bras n'a que des ligamens fort lâches, & n'est point assujettie par un ligament rond comme la cuisse, d'où vient qu'il fait toutes sortes de mouvemens avec vitesse. Quote 2. Ch. XII. p. 106. 4. Il y a un ligament rond qui s'oppose à la luxation. Ce ligament prend son origine de la tête du femur, & s'insere dans la cavité de l'ischion; à la verité il ne s'insere pas directement au fond de la cavité ny au milieu de la tête, ce qui fait qu'il ne peur pas s'opposer à toutes les especes de luxations, comme nous le ferons voir dans les differences. Quo...

Great Compilation. Chapter 40

English version of the article: Архипов СВ. Книга Берешит как великая компиляция текстов и смыслов Второго переходного периода Египта: пилотная культурологическая, медицинская, археологическая и текстологическая экспертиза преданий против традиционной атрибуции. Введение. О круглой связке бедра . 14.02.2026 . The text in Russian is available at the following link: 2026АрхиповСВ . The Book of Genesis as a Great Compilation of Texts and Meanings from the Second Intermediate Period of Egypt: A Pilot Culturological, Medical, Archaeological, and Textological Examination of the Legends versus Traditional Attribution. Chapter 41 By Sergey V. Arkhipov, MD, PhD CONTENT [i] Abstract [ii] Book of Genesis. Chapter 41 Analysis [iii] Notes to Chapter 41 [iv] AI Agent's Conclusion [v] Content [vi] External links [vii] Application [i] Abstract The Book of Genesis (Bereshith) was compo...

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