LCF in 2026 (May)
(Quotes from articles and books published in May 2026 mentioning the ligamentum capitis femoris)
Kim, P. S., Kang, C., Lee, J. K., & Hwang, J. M. (2026). Hip arthroscopy to treat symptomatic paralabral cysts: a retrospective analysis of clinical outcomes. Arthroscopy and Orthopedic Sports Medicine, 13(1), 27-34. [i] e-aosm.org
Ko, H. Y. (2026). Vascular Anatomy of the Extremities and Lungs. In Practical Functional Anatomy for Spinal Cord Injury Rehabilitation: A Guide for Physiatrists and Rehabilitation Specialists (pp. 191-223). Singapore: Springer Nature Singapore. [ii] link.springer.com
Aiba, H., Yamaguchi, M., Kimura, H., & Murakami, H. (2026). Advances in limb-salvage surgery and reconstruction for pediatric bone and soft tissue tumors. Frontiers in Pediatrics, 14, 1817788. [iii] pmc.ncbi.nlm.nih.gov
Bajwa, A., Villar, R., Ulicki, P., & Mazek, J. (2026). Arthroscopic Management of Ligamentum Teres Tears. In Arthroscopy: Basic to Advanced (pp. 969-980). Cham: Springer Nature Switzerland. [iv] link.springer.com
Heimann, A. F., Roshardt, J. A., Schmaranzer, F., & Sutter, R. (2026, May). Role of Imaging in Femoroacetabular Impingement Syndrome: From Pathomechanics to Patient-Specific Management. In Seminars in Musculoskeletal Radiology. Thieme Medical Publishers, Inc.. [v] thieme-connect.com
Stetzelberger, V. M., Heimann, A. F., Amrein, P., Hirt, J., Schwab, J. M., Martinho, T., ... & Tannast, M. (2026). The ligamentum teres as a source of hip pain: evidence of T-cell infiltration and free nerve endings in young active patients undergoing joint preserving surgery. Journal of Hip Preservation Surgery, hnag023. [vi] academic.oup.com
Kantilaras, A. P. (2026). Plain Photo Overview of Legg Calve Perthes Disease. International Journal of Health and Pharmaceutical (IJHP), 6(2), 306-313. [vii] scholar.google.com
Cohen, E., Fiterman, M., Itkowitz, B., Elaobda, A., Rotkopf, R., Eldada, M., & Benkovich, V. (2026). Surgical alternatives for treatment of developmental dysplasia of the hip in children aged 1–4 years: does open reduction improve the outcomes? European Journal of Orthopaedic Surgery & Traumatology, 36(1), 194. [viii] link.springer.com
Kortibi, M., Razzouk, Q., Issa, M., Sagheer, M., Khaiata, H., & Berro, F. (2026). Ligamentum teres tear with hyaline body formation: A rare cause of mechanical hip pain. Trauma & Case Reports, 101365. [ix] sciencedirect.com
Katzir, A., Norton, J. B., Edwards, D. M., & Starr, A. J. (2026). Percutaneous Hip Containment Technique for Acetabular Posterior Wall Fracture-Dislocation: A Case Report. Journal of Clinical Orthopaedics and Trauma, 103494. [x] sciencedirect.com
Ikemura, S., Utsunomiya, T., Shiomoto, K., Motomura, G., Hamai, S., Kawahara, S., ... & Nakashima, Y. (2026). Comparative effects of intracapsular corticosteroid injection on pain control after total hip arthroplasty: a prospective, randomized controlled trial. Scientific Reports. [xi] nature.com
Buttin, P., Crumière, A., & Goin, B. (2026). A video guide to stabilization of canine hip luxation by intra-articular reconstruction of the round ligament using a synthetic implant. American Journal of Veterinary Research, 1(aop), 1-2. [xii] scholar.google.com
[i] In 62 cases (75.6%), the PC [Paralabral cyst] was accompanied by FAI (cam type: n = 35; pincer type: n = 5; mixed type: n = 22). Labral tears, some of which overlapped with FAI, were present in 73 cases (89.0%; near the PC: 60; isolated: n = 13). Associated lesions, such as ligamentum teres partial tear, subspinal impingement, and internal snapping hip, were found in six (7.3%), four (4.9%), and two (2.4%) cases, respectively.
[ii] Moreover, rupture of the blood vessels supplying the head and neck can lead to ischemic degeneration of the femoral head, as the artery of the ligamentum teres often provides insufficient alternative blood supply.
[iii] The direct anterior approach for femoral head with surgical hip dislocation (DAA-SHD) technique is performed with the patient in a supine position (Yang et al.). A direct anterior incision is made in the Hueter interval between the tensor fasciae latae and sartorius muscles, and the plane between rectus femoris and gluteus medius is developed to expose the anterior hip capsule. With a T-shaped capsulotomy, the ligamentum teres is released and the femoral head is anteriorly dislocated. The tumor is carefully curetted, and the cavity is irrigated with sterile water and ethanol.
[iv] Abstract
Previously overlooked and considered a solely vestigial structure, we now understand that the ligamentum teres (LT) is a significant hip stabiliser with both proprioceptive and nociceptive functions, and a recognised source of hip pain and instability. Tears of the LT can be classified into three categories. Type I complete tears are usually traumatic in origin, and type II partial tears and type III degenerative tears occur more often under chronic conditions, including subluxation/overuse injury and osteoarthritis, respectively. Surgical indications for LT tears have evolved significantly and depend on tear classification. Debridement, using radiofrequency probes and curved shavers, remains effective for the majority of partial tears with mechanical symptoms. However, surgical LT reconstruction using autografts, allografts, or synthetic grafts is indicated in cases of persistent hip instability, particularly in revision arthroscopy. In addition, while diagnosis is challenging, O’Donnel’s LT test and advanced imaging, particularly magnetic resonance arthrography (MRA), improve preoperative identification. Creating bone tunnels in the acetabular fossa and femoral head, graft passage and fixation using EndoButtons, suture anchors and interference screws are key technical steps of the procedure. Careful patient selection, graft preparation, tunnel placement and managing hip position during fixation to achieve optimal graft tension while minimising the risk of neurovascular injury are critical. Arthroscopic management of LT tears have demonstrated promising outcomes. While debridement is associated with exceptional short-term outcomes, some patients experience recurrent LT tears. Similarly, LT reconstruction provides significant improvements across several patient-reported outcome measures, pain and stability, accelerating return to sport, but is associated with a reoperation rate of 33%. With further advances in surgical innovation, there is a recognised need to refine surgical indications for both procedures. In particular, LT reconstruction requires careful evaluation of the graft options, donor sites and associated risks and benefits.
[v] The ligamentum teres is routinely evaluated as part of comprehensive hip MRI and affected in some patients with FAIS. Partial or complete tears, hypertrophy, and surrounding edema can be identified …
[vi] Abstract
The ligamentum teres (LT) is frequently found injured during hip arthroscopy in young, active patients, yet its functional relevance remains uncertain. Although not a primary stabilizer, the LT may contribute to intra-articular pain through nociceptive and proprioceptive mechanisms. Most existing histological studies focus on older arthroplasty patients or cadaveric specimen leaving limited information on young adults undergoing joint-preserving surgery, which is the population at risk.
This study aimed to determine (i) the presence of mechanoreceptors—specifically Vater–Pacinian corpuscles and Ruffini endings—and (ii) the presence of T-cell infiltration as a marker of inflammation. LT samples were harvested intraoperatively from 21 consecutive patients undergoing surgical hip dislocation (April–September 2019). After excluding individuals with prior hip surgery or Legg–Calvé–Perthes disease, 16 specimens were analysed. Preoperative anteroposterior pelvis radiographs and CT determined hip morphology. Samples were paraffin-embedded, stained with Masson–Goldner, and examined histologically. Immunohistochemistry with SMI-31 and S100 identified nerve fibres, while CD3 staining detected T-lymphocytes. Lymphocyte infiltration was graded as absent, moderate, or severe.
No type I–III mechanoreceptors were found in any specimen, although all LTs contained unmyelinated free nerve endings (type IV). T-cell infiltration was present in 88% of samples, most commonly in the mid-substance, followed by the acetabular and femoral regions.
These findings support the LT as a potential source of hip pain in young patients, reflecting both sensory innervation and immune activation. Recognition of LT pathology may aid in diagnosing unexplained intra-articular hip pain and guide targeted management.
Level of Evidence: IV.
[vii] Stability in the pelvis is due to the deep acetabulum. Stability is enhanced by the joint capsule and the strong muscles and ligaments surrounding it. The hip capsule is a dense, fibrous structure that includes the iliofemoral, pubofemoral, and ischiofemoral ligaments. These ligaments, along with the ligamentum teres and the labrum, provide pelvic stability.
[viii] OR [open reduction] were performed through a bikini anterior approach, including capsulotomy, psoas release, excision of the ligamentum teres and pulvinar, and transverse ligament incision, followed by capsuloraphy after reduction.
[ix] Abstract
Introduction
Traumatic injuries of the ligamentum teres (LT) are an underrecognized cause of hip pain and instability. Diagnosis is often delayed due to nonspecific symptoms and normal radiographs. Complete LT rupture associated with intra-articular hyaline body formation is rare and may result in chronic mechanical symptoms.
Case presentation
A 38-year-old female presented with progressive right hip pain and limping over two years following direct blunt trauma. Symptoms evolved into mechanical pain, instability, and restricted motion despite conservative management. Clinical examination revealed an antalgic gait, positive Trendelenburg sign, and reduced hip rotation. Radiographs were unremarkable, while magnetic resonance imaging suggested LT injury with joint effusion. Open surgical exploration via a modified Gibson approach revealed a complete LT rupture with multiple intra-articular hyaline bodies within the acetabular fossa, contributing to femoral head instability. Surgical management included excision of loose bodies, reduction, and capsular stabilization.
Discussion
This case highlights a rare post-traumatic combination of complete LT rupture and hyaline body formation leading to chronic instability. It emphasizes the importance of maintaining clinical suspicion in patients with persistent mechanical symptoms despite normal imaging. In resource-limited settings, open surgical approaches provide effective diagnosis and treatment when arthroscopy is unavailable.
Conclusion
Post-traumatic LT rupture with hyaline bodies is a rare but treatable cause of chronic hip instability. Early recognition and appropriate surgical management can lead to excellent functional outcomes.
[x]
An 18-year-old woman involved in a motor vehicle collision sustained a pelvic ring fracture and a right hip posterior wall acetabular fracture-dislocation. She was taken to the operating room for minimally invasive reduction and fixation of the pelvic ring fracture, as well as an examination under anesthesia (EUA) of the acutely reduced right hip. The hip fracture-dislocation was found to be unstable, and she subsequently underwent a minimally invasive hip containment surgery using a transfemoral neck tunnel through the quadrilateral surface and a TightRope suture EndoButton application. At 1 year postoperatively, the patient is pain-free and has returned to full activity with no residual instability. Hip containment with a TightRope device may be considered to maintain stability in unstable acetabular posterior wall fracture-dislocations.
The mechanical concept is based on previous literature highlighting the importance of the ligamentum teres as a hip stabilizer, as well as recent arthroscopic reconstruction experience, with the aim of recreating the ligamentum teres …
[xi] Another unique feature of this study is that the injection was administered solely into capsular tissue of the hip joint capsule [5]. This approach is anatomically justified, as nociceptors are widely distributed throughout the hip capsule, with particularly high concentrations at the labral base and ligamentum teres [9].
9. Ross JA, Greenwood AC, Sasser P 3rd, Jiranek WA. Periarticular Injections in Knee and Hip Arthroplasty: Where and What to Inject. J Arthroplasty. 2017;32:S77-80.
[xii] Objective
To provide video guidance on performing intra-articular repair of the round ligament with a synthetic implant to stabilize the coxofemoral joint following hip luxation in dogs.
Animals
Dogs of any size with hip luxation associated with rupture of the round ligament.
Methods
With the dog in lateral recumbency, a femoral tunnel is drilled from the base of the greater trochanter to the fovea capitis. A second femoral tunnel is drilled caudocranially, distal and perpendicular to the first one, midway between the medial and lateral cortices of the proximal femoral metaphysis. This tunnel is compacted with an interference screw intended for implant fixation. A third tunnel is drilled through the acetabulum at the footprint of the round ligament. An ultra-high-molecular-weight polyethylene (UHMWPE) implant preassembled with a cortical button is inserted through the acetabular tunnel, such that the button lies against the medial wall of the acetabulum. The implant is passed through the femoral tunnels, tensioned, and secured in the second femoral tunnel with the use of an interference screw inserted caudocranially.
Results
This technique provides immediate stabilization and restores physiological mobility of the hip.
Clinical Relevance
Hip luxation is a common traumatic lesion in small animals. The choice of surgical treatment depends on the type of hip luxation, which usually occurs in a craniodorsal direction and more rarely in a caudodorsal or caudoventral direction. Intra-articular repair replaces the torn round ligament with a biocompatible UHMWPE implant to restore the stability and mobility of the joint. This technique allows for treatment of all luxation types.
Author:
Arkhipov S.V. – candidate of medical sciences, surgeon, traumatologist-orthopedist.
Keywords
ligamentum capitis femoris, ligamentum teres, ligament of head of femur, history .
Comments
Post a Comment