We aimed to compare clinical and radiologic outcomes in patients with cam-type femoroacetabular impingement (FAI), with and without a partial ligamentum teres (LT) tear, who underwent hip arthroscopy (HA) with ≥10 years of follow-up. Among the patients who underwent HA for a cam-type FAI diagnosis with a labral tear, 28 patients (28 hips) with a partial LT tear and 87 patients (99 hips) with an intact LT were assigned to Groups A and B, respectively. All patients underwent partial labral debridement and femoroplasty. Debridement and thermal shrinkage were performed for LT tears. The grade of chondral damage was measured intraoperatively. Clinical items were assessed preoperatively and at the last follow-up. Patients' satisfaction with the surgery and changes in postoperative sports ability in those who had previously been active in sports were assessed at the last follow-up. The Tönnis grade was assessed preoperatively and at the last follow-up for radiologic evaluation. Chondral damage to the acetabular and femoral head detected intraoperatively was significantly different between the groups ( = 0.005 and < 0.001). At the last follow-up, Group A patients experienced more difficulty performing sports activities than Group B patients ( = 0.056), and significantly, more Group A patients had stopped exercising despite their active participation in sports preoperatively ( = 0.002). Regarding the Tönnis grade, significant differences were found only at the final follow-up ( = 0.020). Patients with partial LT tear showed a higher grade of chondral damage, experienced decreased exercise capacity and had significantly worsened Tönnis grades, suggesting hip osteoarthritis progression compared to those with an intact LT.
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http://dx.doi.org/10.1093/jhps/hnab080 | DOI Listing |
J Orthop Traumatol
December 2024
Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy.
Background: The ligamentum teres (LT) has received attention in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). Indeed, a better understanding of the function of the LT and its implications for clinical outcomes in the presence of a torn LT is required. This systematic review analyses the patient-reported outcome measures (PROMs) and the complication rate when an intact or torn LT is encountered during HA for FAI.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Obstetrics & Gynaecology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
A woman in her early 20s presented with a huge pedunculated tumour of the vulva which had progressively increased in size over the course of 10 years. Clinical examination revealed a pedunculated solid mass arising from the right labia majora measuring 15×15 cm. CT scan showed a multilobulated mass arising from the right round ligament suggestive of an extrauterine fibroid.
View Article and Find Full Text PDFJBJS Essent Surg Tech
December 2024
Sports Medicine Center, Department of Orthopaedics, Massachusetts General Hospital, Mass General Brigham, Boston, Massachusetts.
Background: Whereas uncomplicated labral tears with preserved fibers can be effectively treated with use of labral repair techniques, complex tears and hypoplastic labra require labral reconstruction. Standard reconstruction techniques feature grafted tissue that is added to existing, deficient tissue or that is utilized to replace a hypoplastic labrum entirely. However, such approaches utilizing allografts or remote autografts are limited because they often necessitate extensive debridement of the existing labrum to prepare a site for graft implantation, an approach that can damage and devascularize the chondrolabral junction.
View Article and Find Full Text PDFOrthop J Sports Med
November 2024
Department of Sports Orthopaedics, Hoshigaoka Medical Center, Osaka, Japan.
Background: Anatomic rectangular tunnel anterior cruciate ligament reconstruction (ART-ACLR) can mimic the fiber arrangement of the native ACL and restore normal knee biomechanics, compared with the conventional round tunnel ACLR. ART-ACLR using a bone-patellar tendon-bone (BPTB) graft can provide satisfactory clinical outcomes; however, some issues such as secondary ACL injury and donor-site morbidity, including postoperative anterior knee pain (AKP), remain to be solved. Due to these issues, quadriceps tendon-bone (QTB) grafts have recently become more popular.
View Article and Find Full Text PDFJ Clin Orthop Trauma
November 2024
Department of Orthopaedics, Hayatabad Medical Complex, Peshawar, Pakistan.
Hip arthroscopy has emerged as the primary surgical intervention for Femoroacetabular Impingement Syndrome (FAIS), a common cause of hip pain in young adults, particularly athletes. This narrative review examines the long-term outcomes, complications, and debates surrounding arthroscopic management of FAIS. Key findings include sustained improvements in patient-reported outcomes, return to sport, and functional recovery, particularly in younger patients and those with cam-type FAIS.
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