LCF in 2025 (December)
(Quotes from articles and books published in December 2025 mentioning the ligamentum capitis femoris)
Sarassa, C., Aristizabal, S., Mejía, R., García, J. J., Quintero, D., & Herrera, A. M. (2025). Intraosseous Tunneling and Ligamentum Teres Ligamentodesis “Teretization” to Enhance Stability in Congenital Hip Dislocation Surgery: Surgical Technique and Mid-Term Outcomes. Journal of Pediatric Orthopaedics, 10-1097. [i] journals.lww.com
Kampouridis, P., Svorligkou, G., Spassov, N., & Böhme, M. (2025). Postcranial anatomy of the Late Miocene Eurasian hornless rhinocerotid Chilotherium. PLoS One, 20(12), e0336590. [ii] journals.plos.org
Burdette,
T. N., Hsiou, C. L., McDonough, S. P., Pell, S., Ayers, J., Divers, T. J.,
& Delvescovo, B. Sidewinder syndrome associated with complete rupture of
the ligamentum capitis ossis femoris in a horse. Equine Veterinary Education. 05
December 2025. https://doi.org/10.1111/eve.70036 [iii] beva.onlinelibrary.wiley.com
Hagen, M. S., DeFroda, S., Zhang, A. L., & Insights, I. (2025). Contemporary Hip Arthroscopy: Approaches and Outcomes. Sports Medicine. [iv] sportsmed.org
Hayward, J. J., Garrison, S., Hernandez, I., Southard, T., Lin, L., Grenier, J. K., ... & Todhunter, R. J. (2025). Transcriptomes of thirteen healthy feline tissue types. BMC genomics. [v] ink.springer.com
Siyu, H. A. N., Song, L. I., Di, J. I. A., Yanlin, L. I., & Guofeng,
C. A. I. (2025). Effectiveness of arthroscopic treatment for femoroacetabular
impingement syndrome combined with ligamentum teres injury. Chinese Journal
of Reparative and Reconstructive Surgery, 39(12), 1551.
[vi] pubmed.ncbi.nlm.nih.gov
Cotzia, M. V. (2025). FEM-NEURODESIGN-Neuromorphic Approach to the
Biomechanical Design of Internal Fixation (Doctoral dissertation, Politecnico di
Torino). [vii] webthesis.biblio.polito.it
Kuruwa, D. R., Ashraf, M., & George, P. (2025). Snapping Hip:
Internal and External. In Orthopaedic Sports Medicine: An Encyclopedic Review
of Diagnosis, Prevention, and Management (pp. 1-20). Cham: Springer Nature Switzerland. [viii] link.springer.com
Juric, M., Kashanian, K., Lameire, D. L., Abdel Khalik, H., Champagne, A., Dwyer, T., ... & Chahal, J. (2025). Circumferential Repair Versus Labral Base Refixation for the Treatment of Symptomatic Femoroacetabular Impingement Syndrome: A Systematic Review and Narrative Synthesis. Orthopaedic Journal of Sports Medicine, 13(12), 23259671251389140. [ix] journals.sagepub.com
Atinga, A., Mellado Santos, J. M., Albareda, J. A., Hualde Enguita, A.
M., & Llopis, E. (2025). Acute Osseous Injury to the Hip and Proximal
Femur. In Musculoskeletal Imaging (pp. 1-44). Cham: Springer Nature Switzerland.
[x] link.springer.com
Matsumura, D., Hashimoto, T., Moritake, A., Yamagishi, K., Nakagawa, K., & Goto, P. K. (2025). EP124 Varus osteotomy induced bone regeneration of the femoral head necrosis caused by ligamentum teres rupture. A case report. Journal of Hip Preservation Surgery, 12. [xi] pmc.ncbi.nlm.nih.gov
Chan, Y. S., & Hsu, C. H. (2025). AS2. 3 Risk Factors for Conversion to Total Hip Arthroplasty After Hip Arthroscopy in Patients Over 40 Years Old. Journal of Hip Preservation Surgery, 12. [xii] pmc.ncbi.nlm.nih.gov
Yin, Q. (2025). EP180 Hip Arthroscopy with Outside-in Longitudinal Capsulotomy and Comprehensive Capsular Closure Achieves Good Clinical Outcomes in Symptomatic Borderline Dysplasia of the Hip: A Retrospective Study with Mean 2-Year Follow-up. Journal of Hip Preservation Surgery, 12. [xiii] pmc.ncbi.nlm.nih.gov
Arkhipov, S.V. (2025) Enhancing Postoperative Comfort and Improving the Reliability of a Hip Prosthesis by Incorporating Artificial Ligaments: Concept Demonstration and Prototype. About Round Ligament of Femur. December 28, 2025. DOI:10.13140/RG.2.2.15175.15524 [xiv] roundligament.blogspot.com , researchgate.net
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Abstract
Background
Developmental dysplasia of the hip (DDH) with complete
dislocation (grade ≥III) in older patients often requires open reduction. However, achieving long-term stability
remains challenging. This study introduces and evaluates a novel surgical
technique, intraosseous tunneling and ligamentodesis of the ligamentum teres
(LT), conceived to enhance postoperative hip stability while preserving the
ligament’s anatomic course.
Methods
Pediatric patients with grade ≥III DDH, as classified
by the International Hip Dysplasia Institute (IHDI), underwent open reduction
using a novel ligamentum teres ligamentodesis technique to enhance joint
stability. The ligament was
detached, sutured, and tunneled intraosseously from the fovea to the greater
trochanter, then anchored to the periosteum. Postoperative evaluation included
gait status, pain, hip range of motion, reluxation, residual dysplasia,
avascular necrosis (AVN), physeal bars, growth arrest, complications, and need
for reintervention.
Results
Nineteen hips in 16 patients (14 females, 2 males)
with a median age of 24 months underwent LT intraosseous ligamentodesis
combined with femoral and pelvic osteotomies. At a median follow-up of 23 months, all patients were pain-free, had
normal gait, and no functional limitations, except for one case of persistent
limping and one hip with mild limitation of abduction. Radiographically, all
hips achieved satisfactory outcomes with IHDI type I, and severing grades I
(80%) and II (20%). No cases of redislocation, dysplasia, infection, physeal
bars, or growth arrest were observed. Two hips (10.5%) developed asymptomatic
AVN.
Conclusions
The ligamentum teres intraosseous ligamentodesis
(“Teretization”) is a safe and technically feasible adjunct to open reduction
in severe DDH, demonstrating favorable mid-term outcomes with no redislocations
and low complication rates. These
findings support its potential role in enhancing hip stability without
jeopardizing femoral head physis and vascularity.
Level of Evidence
Level IV—therapeutic case series. This study evaluates
a novel surgical technique in a series of patients with congenital hip
dislocation without a control group.
The femoral head is
protruding from the shaft and positioned higher than the greater trochanter,
which is restricted to a slightly protruding, prominent tuberosity on the
lateral side of the bone. On the posterior side of the femoral head, the fovea
capitis is very high and narrow.
.jpg)
Fig 12. The femur of chilotheres.
A–E, Chilotherium persiae (Pohlig, 1885) [19] (MNHN.F.MAR3921, left) from Maragheh (Iran), F–J, Chilotherium habereri (Schlosser, 1903) [24] (GPIT/MA/04835, left) from Kutschwan (China), and K–P, Chilotherium schlosseri (Weber, 1905) [14] (AMNH-20647, left) from Samos (Greece) in anterior (A, F, and K), posterior (B, G, and L), medial (C, H, and M), lateral (D, and N), proximal (J, and O), and distal (E, and P) views. Abbreviations: fc, fovea capitis, gt, greater trochanter; h, femoral head; mc, medial condyle; lc, lateral condyle; lt, lesser trochanter; pat, articular trochlea for the patella; tf, trochanteric fossa; and tt, third trochanter. Scale bar equals 10 cm. (open access article) https://doi.org/10.1371/journal.pone.0336590.g012
Sidewinder syndrome
associated with complete rupture of the ligamentum capitis ossis femoris in
a horse
A 10-year-old mixed-breed gelding was admitted to
a referral hospital following the acute onset of an asymmetrical hind end gait.
The abnormal gait was characterised by marked leaning of the hindquarters to
the left while standing and ambulating. While stalled, the horse was also
observed to intermittently lean to the left and rest the left pelvic area
against the wall for support. Medical management with anti-inflammatories and
antiprotozoal medications had not improved the condition. The neurologic examination
upon presentation did not find ataxia but the horse had a pronounced and
consistent hind end tracking gait to the left. No definitive cause for the gait
abnormality was identified from the clinical exam. Although advanced imaging of
the upper portion of the pelvic limbs, the pelvis and caudal spine in addition
to a spinal tap were offered, euthanasia was elected by the owner because of
lack of response to the recent medical treatments and a guarded prognosis for
return to the intended performance level. Post-mortem examination revealed
coxofemoral osteoarthritis with a complete rupture of the right ligamentum
capitis ossis femoris (LCOF) as the cause of the sidewinder gait. Complete
rupture of the LCOF contralateral to the leaning side, should be considered
amongst the differential diagnoses for the acute onset of sidewinder gait in
horses.
Additionally, there are case reports of
techniques such as ligamentum teres debridement or reconstruction and
arthroscopic-assisted acetabular fracture fixation. There are also
extra-articular applications of hip arthroscopy in the peritrochanteric and ischiofemoral
spaces, as well as tendon releases about the hip.
Background
The domestic cat, Felis catus, is a popular worldwide pet but is prone to many genetic diseases in both purebred and random-bred cats. Many of these genetic diseases can serve as important feline models of cognate human diseases. To help understand the fundamental basis of some of these diseases and because healthy tissue sequence is difficult to obtain, we provide a resource of transcriptome sequences from thirteen healthy feline tissue types (adipose, brain cortex, hip joint capsule, cardiac, renal cortex, renal medulla, ileum, jejunum, liver, pancreas, round ligament of the femoral head, skin, and thyroid gland). These represent the tissue types affected with common complex diseases of cats diagnosed at the Cornell University Companion Animal Hospital.
Objective
To investigate the effectiveness
of hip arthroscopy in the treatment of patients with femoroacetabular
impingement (FAI) syndrome combined with ligamentum teres injury.
Methods
A retrospective analysis was
conducted on 23 patients (23 hips) with Cam-type FAI syndrome combined with
ligamentum teres injury who met the selection criteria between April 2022 and
May 2024. The cohort included 12 males and 11 females, with a mean age of 29.16
years (range, 16-57 years). According to Tönnis classification, there were 5
cases of grade 0, 10 cases of grade Ⅰ, and 8 cases of grade Ⅱ
in hip osteoarthritis. The disease duration ranged from 6 to 24 months, with an
average of 12 months. Under hip arthroscopy, hypertrophic synovium and the
damaged ligamentum teres were debrided, while the torn labrum and cartilage
were repaired, and femoral head-neck osteoplasty was performed to eliminate
impingement, restore the normal morphology of the acetabulum and femoral
head-neck, and suture the joint capsule. Acetabular lateral center-edge angle
(LCEA) and α angle (reflecting the degree of
non-sphericity at the femoral head-neck junction) were measured before and
after operation, and the modified Harris hip score (mHHS), the International
Hip Outcome Tool-12 (IHOT-12), and the visual analogue scale (VAS) score for
pain were evaluated.
Results
The operation was successfully
completed in all patients. The incisions healed by first intention after
operation, and there was no perioperative complications such as iatrogenic
cartilage injury, fracture, infection, neurovascular traction injury, or lower
extremity venous thrombosis. All the 23 patients were followed up 12-24 months,
with an average of 14.6 months. The pain of hip joint significantly relieved,
and the function of hip joint improved; no complication such as joint
stiffness, joint instability, and osteonecrosis of the femoral head occurred.
The α angle, VAS score, mHHS score,
and IHOT-12 score at last follow-up were significantly better than those before
operation ( P<0.05); there was no
significant difference in LCEA compared to preoperative value ( P>0.05).
Conclusion
Hip arthroscopy is a safe and
effective treatment for patients with FAI syndrome combined with ligamentum
teres injury, which can achieve satisfactory effectiveness.
The femur is a fundamental bone for the transmission of body weight and
for gait stability during walking. It is stabilized by capsular and ligamentous
structures that limit its movements and protect its integrity. These structures
are part of the hip joint (coxofemoral joint), which is a ball-and-socket
(synovial enarthrosis) joint, covered with cartilage to reduce friction. The
round ligament (ligamentum teres femoris) connects the fovea capitis to the
acetabulum but plays a secondary role compared to the capsular ligament [48,
49, 50]. Its morphological characteristics reflect functional adaptations to
upright posture and walking [51].
The surface of the femoral head is smooth and covered with hyaline
cartilage, except for a small medial area called the fovea capitis, a bony depression
that serves as the insertion point for the ligament of the femoral head
(ligamentum teres femoris). The Latin term fovea means “dimple” or “small
cavity,” accurately describing this anatomical structure. This ligament is a
loose, non-tensioned structure that does not contribute significantly to joint
stability but plays an important role in the vascularization of the femoral
head, especially in young people.
Blood supply is divided into three distinct components, as described by
Crock [55, 61]: • Extracapsular arterial ring, originating anteriorly from the
lateral circumflex femoral artery and posteriorly from the medial circumflex
femoral artery. • Ascending intracapsular cervical branches of the
extracapsular ring, known as retinacular arteries. • The artery of the round
ligament (ligamentum teres).
Intra-articular
snapping may be due to loose bodies, labral tear, synovial chondromatosis,
muscle tears though rare (rectus femoris/ IP), ligamentum teres tears,
osteophytes, or osteochondritis dissecans [9–11].
The following data were collected from studies if available: study
characteristics (author[s], year, title, journal, recruitment period, country,
study design, level of evidence, inclusion and exclusion criteria),
intervention groups, number of patients, follow-up length, participant
characteristics (age, sex, laterality, type of FAIS), intraoperative findings
(Seldes classification, traction time, acetabular Outerbridge grade, femoral
head Outerbridge grade, ligamentum teres tears), concomitant procedures as
demonstrated in Table 1 (debridement, capsular repair, iliopsoas release, rim
trimming, chondroplasty, osteoplasty, trochanteric bursectomy, acetabuloplasty,
femoroplasty, selective debridement of ligamentum teres, microfracture), …
[to
the femoral head] arterial branches originating at the anterior and posterior
circumflex arteries, but also by a branch of the obturator artery coursing
through the ligamentum teres, the foveal artery [8, 9]. Most hip dislocations lead to disruption of ligamentum
teres …
Abstract
We report a rare case of
traumatic osteonecrosis of the femoral head, which was caused by rupture of the
ligamentum teres, in which femoral varus osteotomy was performed and bone
regeneration occurred at the necrotic area.
Background
She was a
20 years old female. She was a short-distance runner and got injured during
competition at the age of 14. She was diagnosed as avulsion fracture of the
attachment of the left ligamentum teres, and received conservative treatment.
After the pain relieved, she continued running exercise. However, she began to
feel left hip pain again from 10 months before, and was referred to our
hospital.
Results
MRI and
CT examination indicated the osteonecrosis of the medial side of left femoral
head and bone defect of the medial weight bearing area. To address that, we
performed femoral varus osteotomy using angular plate and screws. She was
allowed 1/3 partial weight bearing at 6 weeks postoperatively, and full weight
bearing at 18 weeks postoperatively. After confirmation of bone union at the
osteotomy site at 10 months postoperatively, removal of the plate and screws
concomitant to hip arthroscopy was performed. Hip arthroscopy showed a rupture
of the ligamentum teres, but no apparent defect of the cartilage around
necrotic area of the femoral head was detected. She was allowed full weight
bearing at 2 months after hardware removal.
At the time of 13 months after osteotomy, she was able to walk alone without claudication and have no limitation in hip range of motion. Plain radiography and CT indicated bone repair at the preoperative bone defect area.
Discussion
In this
case, the interruption of the blood supply via ligamentum teres at the time of
injury might result in the osteonecrosis of the femoral head which was limited
to the medial side. Femoral varus osteotomy reduced the load on the necrotic
area and probably induced angiogenesis followed by bone regeneration in the
necrotic area.
Abstract
Background
Hip arthroscopy is commonly performed for various hip pathologies;
however, patients over 40 years old have an increased risk of conversion to
total hip arthroplasty (THA). Identifying risk factors for THA conversion can
improve patient selection and surgical planning.
Hypothesis/Purpose
This study aims to identify preoperative and intraoperative risk factors
associated with THA conversion following hip arthroscopy in patients over 40
years old.
Study Design
Retrospective cohort study.
Methods
A total of 211 patients aged >40 years who underwent primary hip
arthroscopy by a single surgeon between 2013 and 2023 were analyzed.
Preoperative radiographic parameters, including lateral center-edge angle
(LCEA), acetabular depth-to-width ratio (ADWR), and acetabular angle, were
assessed alongside intraoperative findings such as chondral damage and
ligamentum teres tears. Patient-reported outcomes (PROs) were evaluated using
the modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and visual analog
scale (VAS). Logistic regression and receiver operating characteristic (ROC)
curve analysis were performed to identify significant predictors of THA
conversion.
Results
Conversion to THA occurred in 16 patients (7.5%). The conversion group
had significantly lower LCEA (23.4° vs. 27.2°, p = 0.015) and higher acetabular
angle (42.4° vs. 39.5°, p = 0.004), along with a higher incidence of ligamentum
teres tears (38% vs. 19%, p = 0.019). Logistic regression identified lower LCEA
(OR = 0.804), increased acetabular angle (OR = 1.144), and ligamentum teres
tears (OR = 1.277) as independent risk factors for THA conversion (p <
0.05). ROC analysis demonstrated strong predictive accuracy (AUC = 0.87). While
PROs improved postoperatively in both groups, only HOS showed a statistically
significant difference, though of minimal clinical relevance.
Conclusion
Lower LCEA, increased acetabular angle, and ligamentum teres tears are
significant risk factors for THA conversion after hip arthroscopy in patients
over 40 years old. Identifying these factors preoperatively may enhance
surgical decision-making and patient counseling regarding long-term joint
health.
Objective
To introduce a set
of hip arthroscopic capsular management for patients with symptomatic
Borderline Developmental Dysplasia of the Hip and evaluate its clinical
outcomes at a mean 2-year follow-up.
Result
Fifty-three patients were finally enrolled with an average age of 35.4±10.9 years and a mean follow-up of 2.6±1.5 years. Beside common findings such as labral tear, cartilage injure, and ligamentum teres injuries, a relative thinner anterior capsule was confirmed 4.6±1.0 mm. Comprehensive capsular closure was performed in all cases. Significant improvements were observed in iHOT-12 (44.6±8.2 VS 79.9±7.1), VAS (3.7±1.0 VS 1.1±0.8) and WOMAC (19.4±9.7 VS 9.7±4.0) from preoperative to the final follow-up (P < 0.0001). No significant complications were found in all patients.
Abstract
The principle of operation of an experimental total hip endoprosthesis augmented with ligament analogs has been demonstrated in single-leg vertical stances and at the mid-stance phase of the single-support period of gait. The experiments were conducted on a specially designed mechatronic testing rig. The concept of the important role of the ligamentous apparatus is further illustrated by a set of demonstrative mechanical models. The data obtained from the experiments enabled the development of a prototype total hip endoprosthesis incorporating an analog of the ligamentum capitis femoris (LCF), exhibiting pronounced anti-dislocation properties. The use of ligament analogs is expected to substantially increase the reliability of total hip endoprostheses and improve postoperative patient comfort.
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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