Ligamentum Teres Reconstruction May Lead to Improvement in Outcomes Following a Secondary Hip Arthroscopy for Symptomatic Microinstability: A Systematic Review

Shapira, Jacob; Yelton, Mitchell J.; Rosinsky, Philip J.; Maldonado, David R.; Meghpara, Mitchell B.; Ankem, Hari K.; Lall, Ajay C.; Domb, Benjamin G.

doi:10.1016/j.arthro.2021.01.022

Cited by 7 publications

(12 citation statements)

References 22 publications

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“… 7 , 8 , 9 The suction seal it produces reduces cartilage stress and strain by providing a pressurized layer of synovial fluid to distribute compressive loads evenly. 7 , 9 , 10 , 11 , 12 Labral tear and the resulting joint pain are indication for hip arthroscopic surgery. 13 Labral tear alters the physiology and biomechanics within the hip joint and leads to degenerative changes of the articular cartilage and osteoarthritis over time.…”

Section: Discussionmentioning

confidence: 99%

“… 13 Labral tear alters the physiology and biomechanics within the hip joint and leads to degenerative changes of the articular cartilage and osteoarthritis over time. 7 , 12 Previous surgical management of labral tear focused on arthroscopic labral debridement; however, long-term studies show that labral repair, including suture repair and reconstruction, provides better functional outcome. 7 , 11 , 12 , 14 , 15 Labral reconstruction is a good option for patients with poor labral quality, labral calcification, or segmental defects.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Modified Technique for Labral Reconstruction of Hip Joint Using Autologous Iliotibial Band (ITB)—Make Labral Reconstruction Stress-Free

Tian,

Gao,

et al. 2023

Arthroscopy Techniques

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Modified Technique for Labral Reconstruction of Hip Joint Using Autologous Iliotibial Band (ITB)—Make Labral Reconstruction Stress-Free

Tian,

Gao,

et al. 2023

Arthroscopy Techniques

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“…The systematic review by Shapira et al 8 is an excellent review that starts the conversation on how to best improve LT reconstruction results and how to continue to study this controversial procedure with longer-term follow-up, imaging studies, and biomechanical studies after reconstruction. Industry innovation and partnership also will assist in improving the ease of these difficult, less common operations.…”

Section: See Related Article On Page 1811mentioning

confidence: 99%

Editorial Commentary: Ligamentum Teres Reconstruction May Improve Hip Stability But Has High Revision Rates: Fad or Restoration of Function?

Hartigan¹,

Hegedus²

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Ligamentum teres (LT) tears are correlated with hip instability, and biomechanical research suggests there is a stabilizing function of the intact native LT. With regard to LT reconstruction, currently, there are imaging studies demonstrating that the ligament goes on to heal and properly function. There are also no long-term clinical studies on the success rates of LT reconstruction. The clinical studies that have been done are done with a fairly high number of concomitant procedures, which makes it difficult to discern whether improvement can be attributed to the LT reconstruction. A recent review shows that after LT reconstruction, these very difficult patients can respond favorably to surgery two-thirds of the time. However, in the remaining one-third of patients, an additional surgery was required. In my own practice, patients with instability patterns on examination who have failed primary arthroscopy and have any degree of even minor bony dysplasia with signs of ligamentous laxity and LT tear are a population that I personally would recommend a periacetabular osteotomy to optimize bony stability. For those not a candidate for periacetabular osteotomy , the patient should be educated on the risks of failure of LT reconstruction and have reasonable expectations, and the operation should be performed by an experienced hip arthroscopist with LT reconstruction experience.

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“…Therefore, studies recommend the LT reconstruction surgery in such cases [ 10–13 ]. Since patient-reported early outcomes are favourable [ 14 , 15 ] and numerous studies have already described the detailed surgical technique of the LT reconstruction [ 11 , 16–18 ], it is reasonable to expect the LT reconstruction surgery may become more frequent procedure than before.…”

Section: Introductionmentioning

confidence: 99%

A guide to facilitate the creation of a femoral tunnel for arthroscopic ligamentum teres reconstruction: a three-dimensional computed tomography study

Ismailoglu,

Zeynalov

et al. 2023

Journal of Hip Preservation Surgery

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The ideal femoral tunnel passing through the centre of the femoral neck targeted to the footprint of the ligamentum teres (LT) is established during the LT reconstruction surgery with the free-hand technique. We aimed to quantitatively determine the entry site and define the angular orientation of the ideal femoral tunnel with its relevance to the femoral valgus angle (FVA) and the femoral anteversion angle (FAA) to facilitate the creation of an ideal femoral tunnel during the LT reconstruction surgery. A total of 60 randomly selected CT images were obtained to reconstruct three-dimensional femur models. A virtual reamer representing the ideal femoral tunnel was placed in the femur models. The femur length, FVA, FAA, the femoral tunnel anterior angle, the femoral tunnel superior angle and the skin- and bony-entry sites were measured. The femoral tunnel angular orientation was strongly correlated with the FVA and the FAA. Mathematical formulas were defined by which entry site of the reamer and the anterior and superior angulation of the femoral tunnel could be estimated before the surgery. The mean skin-entry site was 67.3 mm distal and 0.1 mm anterior to the centre of the greater trochanter’s superior border. The angular orientation of the femoral tunnel using FVA and FAA can be easily estimated using mathematical formulas before LT reconstruction surgery. The entry site and angular orientation of the femoral tunnel described in this study can be used to reduce dependency on the usage of fluoroscopy and the workload on the surgeon during the LT reconstruction surgery.

show abstract

Ligamentum Teres Reconstruction May Lead to Improvement in Outcomes Following a Secondary Hip Arthroscopy for Symptomatic Microinstability: A Systematic Review

Cited by 7 publications

References 22 publications

Modified Technique for Labral Reconstruction of Hip Joint Using Autologous Iliotibial Band (ITB)—Make Labral Reconstruction Stress-Free

Modified Technique for Labral Reconstruction of Hip Joint Using Autologous Iliotibial Band (ITB)—Make Labral Reconstruction Stress-Free

Editorial Commentary: Ligamentum Teres Reconstruction May Improve Hip Stability But Has High Revision Rates: Fad or Restoration of Function?

A guide to facilitate the creation of a femoral tunnel for arthroscopic ligamentum teres reconstruction: a three-dimensional computed tomography study

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