LCF in 2026 (January)
(Quotes from articles and books published in January 2026 mentioning the ligamentum capitis femoris)
Villegas
Meza, A. D., Nocek, M., Felan, N. A., Speshock, A., Bolia, I. K., &
Philippon, M. J. (2025). Hip Microinstability: Current Concepts in Diagnosis,
Surgical Management, and Outcomes A Narrative Review. Open Access Journal of
Sports Medicine, 205-221. [i]
tandfonline.com , dovepress.com
Wang,
C. H., Wang, J. H., Lin, Y. H., Shih, C. A., & Hong, C. K. (2026). An
Unusual Mechanical Cause of Hip Subluxation Following Modified Dunn Procedure
for Slipped Capital Femoral Epiphysis: A Case Report. Formosan Journal of Musculoskeletal
Disorders, 10-4103. [ii] journals.lww.com
Alsaghaier, A.
(2026). Results of spica cast in treatment of developmental dysplasia of the
hip in children between 6-18 Months. Journal of Academic Research, 30, 28-43. [iii] lam-journal.ly
Elnewishy, A., Khan, P. Z., Shalan, Y., Khan, S. I., Teama, H.,
Noureldin, M., ... & Shalan Jr, Y. (2026). Labral Repair Versus Labral
Reconstruction in Arthroscopic Treatment of Femoroacetabular Impingement: A
Systematic Review and Meta-Analysis. Cureus, 18(1):e101348. [iv] pmc.ncbi.nlm.nih.gov
Sanjay, P., Diwakar, R., Singh, S., Gujarathi, R. H., Purohit, B. J., & Patni, K. (2026). A Review of Pediatric Orthopedic Disorders: Diagnosis and Treatment Updates. Cureus, 18(1). [v] assets.cureus.com
Arkhipov, S. V. (2026). A Novel Technique for Proximal Fixation of
Ligamentum Capitis Femoris Reconstruction: The Gifts of the Magifor Orthopedic
Surgeons. About Round Ligament of Femur. January 14, 2026. [vi] researchgate.net
Bekmetov, R. A., & Babajanov, K. B. (2025). HISTOMORPHOLOGICAL AND
HISTOCHEMICAL CHANGES IN THE HIP JOINT IN POST-TRAUMATIC COXARTHROSIS. Central
Asian Journal of Medicine, (8), 49-54. [vii] scholar.google.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
Purpose:
To synthesize contemporary evidence on definitions, diagnosis, imaging,
management, and outcomes in hip microinstability and to propose a
phenotype-guided framework grounded in the labrum-capsule-ligamentum teres (LT)
stability continuum.
Mechanistically, capsular ligaments provide the primary rotational and
translational restraints across most of the arc of motion, with the labrum and
ligamentum teres serving as secondary stabilizers.24 The relative contribution
of the ligamentum teres increases in positions of high flexion with adduction
and external rotation, which helps explain the position-dependent increases in
excursion observed following capsular injury or insufficiency.24 This
ligament-angle relationship aligns with clinical observations of apprehension
and giving-way in provocative positions, underscoring the rationale for
measured capsular management and labral seal restoration in surgical treatment
algorithms.24
Ligamentum Teres
The ligamentum teres (LT) augments stability by resisting distraction
and constraining rotation at high flexion angles.39,40 Although the LT’s
contribution to microinstability is adjunctive rather than primary, LT
pathology is observed frequently in athletes who perform extreme ROM.41
Addressing LT lesions in the context of optimized capsulolabral management
leads to symptomatic improvement.42,43
Ligamentum Teres—Function, Indications, and Outcomes
The LT provides measurable end-range rotational restraint and
contributes to distraction resistance, particularly in high
flexion/adduction/external-rotation positions.39,40 Debridement may relieve
symptoms from partial or degenerative tears; LT reconstruction (auto/allograft)
is reserved for refractory instability after labral and capsular
optimization.42
Systematic reviews and ≥ 2-year series report short-term improvements in
PROs, with reoperation rates of approximately 10–20% and limited long-term
survivorship data.42,99 LT reconstruction better serves as an adjunct rather
than a primary stabilizing procedure.43,100 RTS following LT reconstruction is
inconsistent and commonly reported to be around 40–60% in available
series.43,100 Given variable outcomes and lower-level evidence, LT
reconstruction is best viewed as an adjunctive procedure rather than a
stand-alone stabilizer.
Biomechanically, LT contribution is modulated by structural morphology
(length, cross-sectional area, and insertional integrity) and by the status of
the capsulolabral complex.39,40 Shorter or thicker LTs tend to demonstrate
greater stiffness and higher load-to-failure, whereas attenuated ligaments
engage later and tolerate lower loads, predisposing to earlier terminal
rotation.39,40 For these reasons, LT reconstruction is most rational when (1)
labral seal and capsular function have been optimized but symptomatic end-range
rotational laxity persists, (2) imaging or arthroscopy documents marked LT
attenuation or partial absence, and (3) intraoperative testing shows persistent
excess terminal rotation or drive-through despite repair and plication.42,43
Routine primary LT reconstruction is not supported by high-level evidence;
morphology-informed selection (MRI/arthroscopic measurement of LT length and
cross-sectional area (CSA) plus quantitative intraoperative rotation testing)
strengthens mechanistic justification and should be incorporated into future
comparative studies.
Future progress hinges on standard definitions, objective laxity
measurement, multicenter comparative-effectiveness- research, and
rehabilitation trials tailored to microinstability—with specific attention to
the unanswered role of dynamic stabilizers and the durability of LT
reconstruction and femoral head-neck remplissage.16,53,59,66,115
24. van Arkel RJ, Amis AA, Cobb JP, Jeffers JR. The capsular ligaments
provide more Hip rotational restraint than the acetabular labrum and the
ligamentum teres: an experimental study. Bone Joint J. 2015;97–b(4):484–491.
39. Martin HD, Hatem MA, Kivlan BR, Martin RL. Function of the
ligamentum teres in limiting Hip rotation: a cadaveric study. Arthroscopy.
2014;30(9):1085–1091. doi:10.1016/j.arthro.2014.04.087
40. Jo S, Hooke AW, An KN, Trousdale RT, Sierra RJ. Contribution of the
ligamentum teres to hip stability in the presence of an intact capsule: a
cadaveric study. Arthroscopy. 2018;34(5):1480–1487.
doi:10.1016/j.arthro.2017.12.002
41. Wu JY, Li W, Xu LY, Zheng G, Chen XD, Shen C. Ligamentum teres tears
and increased combined anteversion are associated with hip microinstability in
patients with borderline dysplasia. Arthroscopy. 2024;40(3):745–751.
doi:10.1016/j.arthro.2023.06.041
42. de SD, Phillips M, Philippon MJ, Letkemann S, Simunovic N, Ayeni OR.
Ligamentum teres injuries of the Hip: a systematic review examining surgical
indications, treatment options, and outcomes. Arthroscopy.
2014;30(12):1634–1641. doi:10.1016/j.arthro.2014.06.007
43. Shapira J, Yelton MJ, Rosinsky PJ, et al. ligamentum teres
reconstruction may lead to improvement in outcomes following a secondary hip
arthroscopy for symptomatic microinstability: a systematic review. Arthroscopy.
2021;37(6):1811–1819.e1811. doi:10.1016/j.arthro.2021.01.022
99. Hartigan DE, Hegedus CE. Editorial commentary: ligamentum teres
reconstruction may improve hip stability but has high revision rates: fad or
restoration of function? Arthroscopy. 2021;37(6):1820–1821.
doi:10.1016/j.arthro.2021.02.037
100. Rosinsky PJ, Annin S, Maldonado DR, et al. Arthroscopic ligamentum
teres reconstruction: minimum 2-year patient-reported outcomes with subanalysis
of patients with ehlers-danlos syndrome. Arthroscopy. 2020;36(8):2170–2182. doi:10.1016/j.arthro.2020.04.028
Approximately 4% of patients treated with the modified Dunn procedure develop postoperative hip instability, with common causes including capsular laxity, resection of the ligamentum teres, and excessive shortening of the femoral neck.[5] It is clinically crucial to be cautious of residual laxity, as it may compromise postoperative stability, joint congruence, and functional outcomes if left unaddressed.[5]
5. Upasani VV, Birke O, Klingele KE,
Millis MB International SCFE Study Group. Iatrogenic hip instability is a devastating
complication after the modified Dunn procedure for severe slipped capital
femoral epiphysis. Clin Orthop Relat Res 2017;475:1229–35.
Delayed treatment may lead to structural
changes such as inverted labrum, hypertrophied ligamentum teres, pulvinar
tissue, and capsular tightening.
Both autograft and allograft tissues have been successfully used for labral reconstruction, including graft sources such as the iliotibial band, gracilis tendon, and ligamentum teres. In particular, circumferential allograft reconstruction (in which the graft replaces the labrum around the entire acetabular rim) has demonstrated excellent mid-term outcomes and low failure rates in both primary and revision hip arthroscopy settings. 25
25.Allograft labral
reconstruction of the hip: expanding evidence supporting greater utilization in
hip arthroscopy. White BJ, Constantinides SM. Curr Rev Musculoskelet Med.
2022;15:27–37. doi: 10.1007/s12178-022-09741-y.
Open
reduction through an anterior approachin irreducible hips enables the removal
of such obstacles as the pulvinar or hypertrophic ligamentum teres [12].
Fong, A. K., Allen, M. D., Waltzman,
D., Sarmiento, K., Yeates, K. O., Suskauer, S., ... & Loewen, J. L. (2021).
Neuroimaging in pediatric patients with mild traumatic brain injury: relating
the current 2018 Centers for Disease Control guideline and the potential of
advanced neuroimaging modalities for research and clinical biomarker
development. Journal of neurotrauma, 38(1), 44-52.
Abstract:
An experimental technique for reconstruction of the ligamentum capitis
femoris (ligamentum teresfemoris) is described. The proposed method involves
creating two portions of the ligament analog:a pubic portion and an ischial
portion. Fixation of these portions is performed in ischial and pubictunnels
drilled in the corresponding pelvic bones. The technique was tested on a hip
joint model.In arthroscopic reconstruction, it is proposed to provide
visualization through the inferior approachand the femoral tunnel without
distraction in the joint.
Conclusion.
In the case of hip-femoral joint injury, the development of sharp
morphological changes in the ligament of the head of the femur, the tendon
inside the acetabulum, the tendon covering the femur head, and then in the
synovial membrane of the joint bag, the deepening of destructive and
degenerative changes is an irreversible process and is considered the main
indication for endoprosthesis.
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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