Labral Reconstruction Using the Ligamentum Teres Capitis: Report of a New Technique
We have used the ligamentum teres capitis to reconstruct the deficient or absent labrum in five patients with femoroacetabular impingement at the time of surgical hip dislocation. Two had a deficient labrum overlying a sectorial retroverted acetabulum causing pincer-type impingement. Three patients had the labrum previously resected arthroscopically. The minimum followup from surgery was 5 months (average, 10 months; range, 5–20 months). There were no intraoperative or postoperative complications related to the reconstruction. All patients had improvement in their clinical function and one patient underwent total hip arthroplasty at last followup for unresolved pain without radiographic progression of arthritis. Reconstruction of the labrum in patients with deficient or resected labrums at the time of surgical hip dislocation provides the theoretical advantage of sealing and stabilizing the hip joint, restoring the fluid layer which could potentially prevent continued cartilage degeneration.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
KeywordsFemoral Head Round Ligament Femoroacetabular Impingement Ligamentum Teres Labral Repair
We thank Professor Reinhold Ganz for contribution to the knowledge and care of patients with FAI and Karen Fasbender for her help with manuscript preparation.
- 3.Chandler SB, Kreuscher PH. A study of the blood supply of the ligamentum teres and its relation to the circulation of the head of the femur. J Bone Joint Surg Am. 1932;14:834–846.Google Scholar
- 7.Ferguson SJ, Bryant JT, Ganz R, Ito K. The acetabular labrum seal: a poroelastic finite element model. Clin Biomech (Bristol, Avon). 2000;15:463–468.Google Scholar
- 23.Takechi H, Nagashima H, Ito S. Intra-articular pressure of the hip joint outside and inside the limbus. J Japan Orthop Assoc. 1982;56:529–536.Google Scholar