Ligamentum teres tears and femoroacetabular impingement: incidence and preoperative findings

In a recent publication in the journal “ Arthroscopy”, an attempt was made to determine the incidence of injuries of the ligamentum teres detected during hip arthroscopy for the treatment of femoroacetabular impingement, and to identify the clinical examination findings or the radiological features that are specific to complete tears of the ligamentum teres and would help in preoperative diagnosis.
Between October 2006 and June 2015, data were collected prospectively from consecutive hip arthroscopies. The inclusion criteria were primary hip arthroscopy in patients aged 18 years or older. All the patients in the study were treated for labral and articular cartilage dysfunction associated with femoroacetabular impingement. Patients with previous hip surgery were excluded. A total of 2,213 hip arthroscopies were included.
Of the 2,213 hips, 233 had a normal ligamentum teres, 1,947 had a partial tear of it and 33 had a complete tear of the ligamentum teres. A higher incidence of ligamentum teres tears was seen in women. Patients with a ligamentum teres tear had a lower body mass index than those with a normal ligamentum teres. On radiographs, patients with a ligamentum teres tear had a smaller centre-edge angle. An isolated cam or pincer femoroacetabular impingement lesion was seen more often in hips with a ligamentum teres tear than in those without one. Hips with a ligamentum teres tear were 3.1 times more likely to have cartilage lesions of the femoral head than those with a normal ligamentum teres, and were 3.6 times more likely to have capsular laxity diagnosed at hip arthroscopy than those with a normal ligamentum teres.
The authors of this study concluded that, among patients with femoroacetabular impingement and damage to the acetabular labrum, complete tears of the ligamentum teres were rare and were more likely to be seen in women, and in particular in those with a low body mass index and a smaller centre-edge angle. Ligamentum teres tears are associated with laxity of the hip and with cartilage lesions of the femoral head.
Source: “Arthroscopy”, July 2016