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Lesions of the Acetabular Fossa (Ligamentum Teres and Pulvinar)

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Operative Hip Arthroscopy

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Abstract

The acetabular fossa can be a source of significant pathology in the hip joint. Ligamentum teres tears can occur either acutely, often as a result of a hyperabduction injury, or insidiously. Patients with ligamentum teres tears often have mechanical symptoms of catching, locking, and popping. Successful treatment of ligamentum teres tears has been reported with selective debridement alone. Reconstruction of the ligamentum teres has been reported, but the indications for this procedure are still evolving. Other lesions of the acetabular fossa include fibrosis of the pulvinar fat pad, plica, and loose bodies. All of these conditions can be successfully treated with arthroscopic surgery. Often, disorders of the acetabular fossa are not able to be diagnosed prior to surgery. A comprehensive history and physical exam that are suggestive of disorders of the hip joint, a high index of suspicion, and liberal use of diagnostic injections will help identify appropriate surgical candidates. At the time of surgery, a thorough diagnostic arthroscopy with the use of both the 30- and 70-degree arthroscopes will allow the surgeon to appropriately identify and treat pathology of the acetabular fossa.

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Authors and Affiliations

  1. Methodist Sports Medicine — The Orthopedic Specialists, Indianapolis, IN, USA

    G. Peter Maiers II M.D.

  2. Department of Orthopaedic Surgery, Indiana University, 201 N. Pennsylvania PKWY, Suite 100, Indianapolis, IN, 46032, USA

    G. Peter Maiers II M.D.

Authors
  1. G. Peter Maiers II M.D.
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Correspondence to G. Peter Maiers II M.D. .

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Editors and Affiliations

  1. Orthopaedic Center, Baptist Medical Plaza I, Nashville Sports Medicine and, Church Street 2011, Nashville, 37203, Tennessee, USA

    J.W. Thomas Byrd

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Maiers, G.P. (2013). Lesions of the Acetabular Fossa (Ligamentum Teres and Pulvinar). In: Byrd, J. (eds) Operative Hip Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7925-4_15

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  • DOI: https://doi.org/10.1007/978-1-4419-7925-4_15

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-7924-7

  • Online ISBN: 978-1-4419-7925-4

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