Ligamentum teres: a functional description and potential clinical relevance

Martin, RobRoy L.; Palmer, Ian J.; Martin, Hal David

doi:10.1007/s00167-011-1663-1

Cited by 95 publications

(87 citation statements)

References 25 publications

(37 reference statements)

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“…An apprehension test with a provocative maneuver is also executed in the lateral position (Fig. 6c), including a forward force to test antero-inferior instability [22]. Beyond the capsular and teres ligament, this test is also useful to detect acetabular antero-inferior hypoplasia.…”

Section: Lateral Examinationmentioning

confidence: 99%

History and physical examination of the hip: the basics

Martin

Palmer

2013

Curr Rev Musculoskelet Med

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Section: Lateral Examinationmentioning

confidence: 99%

History and physical examination of the hip: the basics

Martin

Palmer

2013

Curr Rev Musculoskelet Med

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“…Studies have also examined the properties of the ligamentous structures of the hip point. Myers et al [29] found the iliofemoral ligament served as a primary stabilizer for limiting external rotation and preventing anterior translation of the femoral head Martin et al [30] conducted a retrospective study of 350 surgical patients that 20 patients identified with complete ligamentum teres rupture. A string model was used to determine the ligament excursion of these subjects.…”

Section: Layer Ii: Inert Layermentioning

confidence: 99%

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

Draovitch

Edelstein

Kelly

2012

Curr Rev Musculoskelet Med

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The level of understanding of pain in the nonarthritic hip has made significant strides in the last couple of decades beginning with the discoveries of Reinhold Ganz, MD. However, even with the detection of subtle bony abnormalities, including femoroacetabular impingement, a clinician's ability to differentiate pain generators in the hip has been ambiguous. Deciphering the etiology of the pathology versus the pain generator is essential in prescribing the proper treatment. The Layer Concept developed by Dr. Bryan Kelly, is a systematic means of determining which structures about the hip are the source of the pathology, which are the pain generators and how to then best implement treatment. Four layers will be discussed in this article. Layer I, the osseous layer, Layer II, the inert tissue layer, Layer III, the contractile layer and Layer IV, the neuromechanical layer.

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“…The effect of LT on hip stability in dysplastic hips and hyperlaxity has been emphasized before [4][5][6]. In their study Martin et al reported that patients with resected LT had feelings of instability and discomfort [5]. The prevalance of LT tears detected at hip arthroscopy varies between 4% and 15% [7] .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Ligamentum Teres Integrity on Hip Scores

Desteli¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Displazik kalçalarda Ligamentum Teres'in (LT) hiperlaksite ve stabiliteye etkisi daha önceki çalışmalarda vurgulanmıştır. LT kesilmiş hastalarda instabilite ve rahatsızlık gözlenmektedir. Duyusal sinir sonlanmalarının varlı-ğı LT'nin eklem propriyosepsiyonu ve nosisepsiyonunda işlevi olduğuna işa-ret etmektedir. Çalışmamızda kalça eklemindeki LT bütünlüğünün klinik işlev-lere etkisinin kıyaslanması amaçlandı. Gereç ve Yöntem: Evre 2-3 koksartrozu olan ardışık 92 hastaya LT testi uygulandı. İç veya dış rotasyonda ağrı LT testinin pozitif olduğunu gösterdi. LT testini takiben hastaların, Kalça Kısıtlılık ve Osteoartrit Sonuç Skoru (HOOS) ve Harris Kalça Skoru (HHS) kaydedildi. Her hastanın etkilenen kalçasından Manyetik Rezonans Görüntüleme (MRG) elde edildi. Bulgular: MR bulguları ile LT testi etkililiği değerlendirildiğinde, sensitivite % 87.37, spesifite ise % 73.47 iken, pozitif ve negatif prediktif değerler sırasıyla % 74.5 ve 80.4 olarak not edildi. MR bulguları ve LT testine göre bağı intakt olan 36 kalça (grup 1) ile bağı yırtık 38 kalça (grup 2) HOOS ve HHS skorları ile karşılaştırıldı. Her iki skorlama da Grup 1'de Grup 2'ye göre önemli ölçüde daha yüksekti (p<0.001). Tartışma: Bilindiği kadarıyla, yırtık ve intakt LT karşılaştırmasıyla bağ bütünlüğünün kalça fonksiyonel skorlarına etkisi literatürde ilk kez çalışmamızda ele alınmaktadır. Ligamentum teres bütünlü-ğünün bozulması, kalça fonksiyonel skorlarını düşürmektedir. Anahtar KelimelerLigamentum Teres; Koksartroz; Kalça; Kalça Skoru Abstract We aimed to compare the clinical functioning of the hips with an intact Ligamentum Teres (LT) to ruptured LT. Patients with resected LT have feelings of instability and discomfort. The effect of LT on hip stability in dysplastic hips and hyperlaxity has been emphasized before. Existence of sensory nerve endings demonstrates that LT has a function in joint proprioception and nociception. LT test was conducted to 92 consecutive patients with Grade 2-3 coxarthrosis. Pain on either internal or external rotation is consistent with a positive LT test result. Following LT test, Hip disability and osteoarthritis outcome score (HOOS) and Harris Hip Score (HHS) were conducted to all of the patients. Each patient underwent MRI Scanning of the involved hip. The efficacy of LT test was evaluated in comparison to MRI findings, sensitivity of the test was 87.37 % and spesificity was 73.47 positive and negative predictive values were found to be 74.51 % nd 80.43 % respectively. 36 hips which had intact LT according to MRI and LT test (Group 1) was compared to the 38 hips with ruptured LT in both LT test and MRI (Group 2) regarding HOOS and Harris Hip Scores. HOOS and Harris Hip Scores of Group 1 were found to be significantly higher than Group 2. As far as we know from the literature this is the first clinical study to investigate the effect of LT integrity on hip scores by comparing hips with ruptured LT to hips with intact LT.

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Ligamentum teres: a functional description and potential clinical relevance

Abstract: IV.

Cited by 95 publications

References 25 publications

History and physical examination of the hip: the basics

History and physical examination of the hip: the basics

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

The Effect of Ligamentum Teres Integrity on Hip Scores

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