Document Detail


Risk factors for ligamentum teres tears.
MedLine Citation:
PMID:  23276414     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to examine the relationship between nontraumatic ligamentum teres (LT) tears and acetabular radiographic architecture.
METHODS: The inclusion criteria for this study were all patients who had anteroposterior pelvis radiographic views and had undergone arthroscopic examination of the LT. The exclusion criteria were Tonnis arthritic grade 3 and traumatic high-energy mechanisms of injury. Radiographic data were measured preoperatively on an anteroposterior pelvis view, including acetabular inclination (AI), lateral center edge (CE) angle, magnitude of cross-over sign, and ischial spine prominence. A Lateral Coverage Index (LCI) was defined as the center edge angle minus acetabular inclination. Hips were divided into 3 groups according to the LCI: (1) high: 34° and above; (2) medium: 19° to 33°; and (3) low: below 19°.
RESULTS: Of the 463 hips (430 patients) included in the study, 226 (49%) had a partial- or full-thickness LT tear. Patients with tears were significantly older than patients without tears (P < .0001), with average ages of 38 and 33 years, respectively. Radiographically, patients with tears had less acetabular retroversion, as reflected by lower ischial spine prominence values and lesser cross-over signs (P = .01 and .0005, respectively). Using the LCI, 115 hips (25%) were classified as high, 236 (50%) as medium, and 114 (25%) as low. Hips with low LCI were 1.74 times more likely to have LT tears than high LCI hips.
CONCLUSIONS: This study found that the presence of LT tears was associated with acetabular bony morphology and age. LT tears were less frequent with high LCI and acetabular retroversion and less frequent in patients younger than 30 years. Further study is needed to establish whether there is a causal relationship between acetabular undercoverage and LT tears and whether LT tears may be a sign of microinstability of the hip.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors:
Benjamin G Domb; Dorea E Martin; Itamar B Botser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  29     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Affiliation:
American Hip Institute, Chicago, Illinois, U.S.A.; Hinsdale Orthopaedics, Hinsdale, Illinois, U.S.A.; Loyola University Stritch School of Medicine, Chicago, Illinois, U.S.A.. Electronic address: DrDomb@americanhipinstitute.org.
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