Function and clinical relevance of the ligamentum teres

Martin, RobRoy L.; Martin, Hal David

doi:10.1097/bco.0000000000000259

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Pathologic processes attributable to the LT have only recently begun to be understood, and the precise function of this structure remains nebulous. 2,[9][10][11] Although clinical examination maneuvers and advanced imaging to detect specific LT pathology remain elusive, the advancement in arthroscopic techniques to address intra-articular pathology of the hip has led to increased understanding of this structure. 6,[12][13][14][15] Tears of the LT can be identified arthroscopically, and are generally classified as type 1 (complete tear), type 2 (partial tear), or type 3 (degenerative).…”

Section: Discussionmentioning

confidence: 99%

Anatomic Arthroscopic Ligamentum Teres Reconstruction for Hip Instability

Menge

Mitchell

Philippon

2016

Arthroscopy Techniques

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There has been growing interest in recent years on the functional importance of the ligamentum teres and its role in hip stability. Partial or complete tearing has previously been treated with debridement or radiofrequency ablation with good results; however, a subset of patients will continue to experience persistent pain or instability with injury to this structure. Advances in arthroscopic instruments and techniques have led to our ability to provide improved care for these patients by performing a ligamentum teres reconstruction. The purpose of this technical note is to describe our method of ligamentum teres reconstruction with a tibialis anterior allograft.

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Section: Discussionmentioning

confidence: 99%

Anatomic Arthroscopic Ligamentum Teres Reconstruction for Hip Instability

Menge

Mitchell

Philippon

2016

Arthroscopy Techniques

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“…Early work by Fuss and Bacher 6 could not identify a unique function for the LT. However, recent studies have offered evidence that the LT does have a purpose in restraining hip rotation range of motion 7,8 and used a ball and string model to describe the function of the LT. [9][10][11][12][13] Femoral head rotation that occurs in the transverse and frontal planes was found to cause the LT to tighten and act as a sling as the LT wrapped around the femoral head. 13 Also, as the LT tightened the femoral head was pulled into the acetabulum, presumably to increase stability at the end range of hip motion.…”

Section: Functionmentioning

confidence: 99%

“…The published reports on the prevalence of LT pathology have varied greatly, ranging from 4% to 93%. 11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] A summary of studies that have described the prevalence of LT pathology is provided in Table 1. More recent studies, published 2007 and later, have noted a higher prevalence than earlier reports.…”

Section: Prevalencementioning

confidence: 99%

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CLINICAL RELEVANCE of the LIGAMENTUM TERES: A LITERATURE REVIEW

Martin

McDonough

Enseki

et al. 2019

Intl J Sports Phys Ther

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Background: The ligamentum teres (LT) continues to be a structure of debate and interest. Previously thought of as a vestigial structure, an awareness of LT pathology and its potential importance has increased with the expansion of hip arthroscopy. Purpose: To provide a comprehensive literature synthesis on the LT and provide clinicians with the most current research regarding the LT and its anatomical features, functional relevance, prevalence of injury, risk factors for injury, clinical presentation, and treatment for pathology. Methods: A systematic literature search was conducted using Medline/PubMed, CINAHL/EBSCO, and Cochrane/ Wiley databases/platforms using the following search terms: ligament, ligament teres, hip, femur, femoral head, round ligament. Results: This search yielded 1284 articles of which 44 met the inclusion/exclusion criteria and contributed to this manuscript. Information on the LT was summarized into the following areas: anatomy, function, injury prevalence, risk factors, mechanism of injury, duration of symptoms, clinical presentation (symptoms, range of motion, functional limitations, special testing), imaging, and treatment. Conclusions: The results of this review supported the following: 1) the LT has a function in restraining hip rotation range of motion; 2) the prevalence of LT pathology in any given population may be largely dependent on the severity of bony deformity (either femoroacetabular impingement(FAI) or dyplasia) and activity level; 3) older age and acetabular bony deformity (either FAI or dyplasia) are risk factors for generalized LT pathology; 4) unique signs and symptoms are difficult to identify because LT pathology rarely occurs in isolation and is likely the end-stage consequence of other hip pathology; 5) the presence of LT pathology may negatively affect an individual's ability to function; and 6) surgical debridement is recommend for pain relief of partial LT tears with reconstruction possible for complete LT tears when complaints of instability are noted.

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“…All the aforementioned studies assume a normal non-dysplastic hip. In the setting of hip dysplasia or capsular laxity, the role of the LT becomes more pronounced in stabilizing the hip [ 34 ].…”

Section: Histologymentioning

confidence: 99%

The role of the ligamentum teres in the adult hip: redundant or relevant? A review

O’Donnell

Devitt

Arora

2018

Journal of Hip Preservation Surgery

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The ligamentum teres (LT) has traditionally been described as a redundant structure with no contribution to hip biomechanics or function. There has been renewed interest in the LT as a source of hip pathology due to the high prevalence of LT pathology observed at the time of hip arthroscopy. The LT acts a secondary stabilizer to supplement the work of the capsular ligaments and works in a sling-like manner to prevent subluxation of the hip at the extremes of motion. The presence of free nerve endings within the LT indicates a definite role in pain generation, with the LT undergoing various mechanical and histological adaptations to hip pathology.

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Function and clinical relevance of the ligamentum teres

Cited by 7 publications

References 19 publications

Anatomic Arthroscopic Ligamentum Teres Reconstruction for Hip Instability

Anatomic Arthroscopic Ligamentum Teres Reconstruction for Hip Instability

CLINICAL RELEVANCE of the LIGAMENTUM TERES: A LITERATURE REVIEW

The role of the ligamentum teres in the adult hip: redundant or relevant? A review

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