Purpose
The purpose of this cadaveric study was to evaluate the function of the ligamentum
teres (LT) in limiting hip rotation in 18 distinct hip positions while preserving
the capsular ligaments.
Methods
Twelve hips in 6 fresh-frozen pelvis-to-toes cadaveric specimens were skeletonized
from the lumbar spine to the distal femur, preserving only the hip ligaments. Hip
joints were arthroscopically accessed through a portal located between the pubofemoral
and iliofemoral ligaments to confirm the integrity of the LT. Three independent measurements
of hip internal and external rotation range of motion (ROM) were performed in 18 defined
hip positions of combined extension-flexion and abduction-adduction. The LT was then
arthroscopically sectioned and rotation ROM reassessed in the same positions. A paired
sample t test was used to compare the average internal and external hip rotation ROM values
in the intact LT versus resected conditions in each of the 18 positions. P < .0014 was considered significant.
Results
A statistically significant influence of the LT on internal or external rotation was
found in 8 of the 18 hip positions tested (P < .0014). The major increases in internal and external rotation ROM occurred when
the hip was in 90° or 120° of flexion.
Conclusions
The major function of the LT is controlling hip rotation. The LT functions as an end-range
stabilizer to hip rotation dominantly at 90° or greater of hip flexion, confirming
its contribution to hip stability.
Clinical Relevance
Ruptures of the LT contribute to hip instability dominantly in flexed hip positions.
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Article info
Publication history
Published online: June 05, 2014
Accepted:
April 7,
2014
Received:
September 2,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding in relation to this article: H.M. receives support from Pivot Medical and Smith & Nephew. Smith & Nephew supplied the cadaveric specimens and laboratory resources for this study.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
