Arthroscopic reconstruction of the ligamentum teres

Philippon, Marc J.; Pennock, Andrew T.; Gaskill, Trevor R.

doi:10.1302/0301-620x.94b11.28576

Cited by 100 publications

(102 citation statements)

References 24 publications

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“…Our results were consistent with prior results and we found the LT test to be an effective tool in detecting LT tears at the outpatient clinic. LT tears associated with symptoms of instability, increased external rotation of the involved hip [23], or tears with accompanying hip joint pathology such as labral tears, patulous capsular tissue, or femoroacetabular impingement may be candidates for reconstruction [24]. Debridement for LT tears is widely considered in current practice; Byrd and Jones [8] and Haviv and O'Donell [25] have reported satisfactory results for debridement.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Ligamentum Teres Integrity on Hip Scores

Desteli¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Displazik kalçalarda Ligamentum Teres'in (LT) hiperlaksite ve stabiliteye etkisi daha önceki çalışmalarda vurgulanmıştır. LT kesilmiş hastalarda instabilite ve rahatsızlık gözlenmektedir. Duyusal sinir sonlanmalarının varlı-ğı LT'nin eklem propriyosepsiyonu ve nosisepsiyonunda işlevi olduğuna işa-ret etmektedir. Çalışmamızda kalça eklemindeki LT bütünlüğünün klinik işlev-lere etkisinin kıyaslanması amaçlandı. Gereç ve Yöntem: Evre 2-3 koksartrozu olan ardışık 92 hastaya LT testi uygulandı. İç veya dış rotasyonda ağrı LT testinin pozitif olduğunu gösterdi. LT testini takiben hastaların, Kalça Kısıtlılık ve Osteoartrit Sonuç Skoru (HOOS) ve Harris Kalça Skoru (HHS) kaydedildi. Her hastanın etkilenen kalçasından Manyetik Rezonans Görüntüleme (MRG) elde edildi. Bulgular: MR bulguları ile LT testi etkililiği değerlendirildiğinde, sensitivite % 87.37, spesifite ise % 73.47 iken, pozitif ve negatif prediktif değerler sırasıyla % 74.5 ve 80.4 olarak not edildi. MR bulguları ve LT testine göre bağı intakt olan 36 kalça (grup 1) ile bağı yırtık 38 kalça (grup 2) HOOS ve HHS skorları ile karşılaştırıldı. Her iki skorlama da Grup 1'de Grup 2'ye göre önemli ölçüde daha yüksekti (p<0.001). Tartışma: Bilindiği kadarıyla, yırtık ve intakt LT karşılaştırmasıyla bağ bütünlüğünün kalça fonksiyonel skorlarına etkisi literatürde ilk kez çalışmamızda ele alınmaktadır. Ligamentum teres bütünlü-ğünün bozulması, kalça fonksiyonel skorlarını düşürmektedir. Anahtar KelimelerLigamentum Teres; Koksartroz; Kalça; Kalça Skoru Abstract We aimed to compare the clinical functioning of the hips with an intact Ligamentum Teres (LT) to ruptured LT. Patients with resected LT have feelings of instability and discomfort. The effect of LT on hip stability in dysplastic hips and hyperlaxity has been emphasized before. Existence of sensory nerve endings demonstrates that LT has a function in joint proprioception and nociception. LT test was conducted to 92 consecutive patients with Grade 2-3 coxarthrosis. Pain on either internal or external rotation is consistent with a positive LT test result. Following LT test, Hip disability and osteoarthritis outcome score (HOOS) and Harris Hip Score (HHS) were conducted to all of the patients. Each patient underwent MRI Scanning of the involved hip. The efficacy of LT test was evaluated in comparison to MRI findings, sensitivity of the test was 87.37 % and spesificity was 73.47 positive and negative predictive values were found to be 74.51 % nd 80.43 % respectively. 36 hips which had intact LT according to MRI and LT test (Group 1) was compared to the 38 hips with ruptured LT in both LT test and MRI (Group 2) regarding HOOS and Harris Hip Scores. HOOS and Harris Hip Scores of Group 1 were found to be significantly higher than Group 2. As far as we know from the literature this is the first clinical study to investigate the effect of LT integrity on hip scores by comparing hips with ruptured LT to hips with intact LT.

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Section: Discussionmentioning

confidence: 99%

The Effect of Ligamentum Teres Integrity on Hip Scores

Desteli¹

2016

Ann Clin Anal Med

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“…7 Only when debridement has failed to result in a good outcome, when instability is the primary symptom, and after concomitant pathology such as femoroacetabular impingement, labral tears, or patulous capsular tissue has been addressed should LT reconstruction be considered. 13 There are several benefits to our technique using allsuture anchors. It allows reconstruction of the LT without the use of metal or plastic anchors that, if dislodgeddwhether inside the joint or into the pelvisd could cause significant harm to the patient.…”

Section: Discussionmentioning

confidence: 99%

“…4,10,11 Several reported techniques for LT reconstruction have resulted in improved patient symptoms and function, specifically regarding stability symptoms. [12][13][14] We report a novel technique using double-loaded "all-suture" anchors in the medial acetabular wall that achieves excellent stability and minimizes the risk of intrapelvic and hip joint injury, as well as complications, by metal or plastic foreign bodies (Tables 1 and 2). …”

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confidence: 99%

A Novel Technique for Ligamentum Teres Reconstruction With “All-Suture” Anchors in the Medial Acetabular Wall

Mei-Dan

McConkey²

2014

Arthroscopy Techniques

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The function of the ligamentum teres remains poorly understood, but tears have been recognized as a source of hip pain. In some patients with complete ligamentum teres tears, symptoms of instability are described. Microinstability and excess motion are hypothesized to be a source of pain and mechanical symptoms. Efforts in recent years to improve symptoms have led to the development of techniques used to reconstruct the ligamentum teres, with some early evidence that reconstruction can improve symptoms in appropriately selected patients. We describe our technique for ligamentum teres allograft reconstruction using anchors made only of suture seated in the acetabular floor.

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“…[LARS], Arcsur-Tille, France) 7 , allografts 25 , a doublestranded semitendinosus autograft 26 , and an iliotibial (IT) band tendon autograft 19 . In the only case series reporting outcomes of LT reconstruction, Philippon et al 19 performed arthroscopic reconstruction of the LT using an IT band autograft in four patients.…”

Section: Reconstruction Of the Ligamentum Teresmentioning

confidence: 99%

Ligamentum teres tendinopathy and tears

Kraeutler

Garabekyan

Pascual‐Garrido

et al. 2016

MLTJ

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SummaryBackground: The ligamentum teres (LT) consists of two bands that originate on the ischial and pubic sides of the acetabular notch and insert on the fovea capitis of the femoral head. Recent studies have established the LT as an important hip stabilizer in a squatting position, particularly in patients with osseous instability. Purpose: This review aims to concisely present the literature on LT tendinopathy and tears in order to guide health care professionals in the appropriate diagnosis and treatment of these disorders. Methods: We reviewed the literature on the diagnosis and surgical management of ligamentum teres tendinopathy and tears. Conclusions: The ligamentum teres is an important stabilizer to the hip joint, particularly with hip flexion and external rotation. Older age and acetabular bony pathomorphology are two of the known risk factors for LT tears. Symptoms of LT tendinopathy are largely non-specific, mimicking a wide range of other hip disorders including impingement and instability. Debridement of LT tears or reactive tissue has been reported with good outcomes, with more recent studies describing reconstruction of a completely torn, nonfunctional, or absent LT using various graft sources including synthetic grafts, autografts, and allografts. Level of evidence: II.

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Arthroscopic reconstruction of the ligamentum teres

Cited by 100 publications

References 24 publications

The Effect of Ligamentum Teres Integrity on Hip Scores

The Effect of Ligamentum Teres Integrity on Hip Scores

A Novel Technique for Ligamentum Teres Reconstruction With “All-Suture” Anchors in the Medial Acetabular Wall

Ligamentum teres tendinopathy and tears

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