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Hip Ligamentum Teres Tear
The Ligamentum Teres (LT), is a triangular band that runs in the floor of the acetabulum, and progressively forms a cord like structure to attach to the femoral head. The understanding of the role that the ligamentum teres serves in the hip joint is still evolving. It is likely that it serves to stabilise the hip at the extremes of motion, and also serves as a check reign to give feedback as to when that limit is approaching.
Injury to the LT is more common in patients who:
- Have had a traumatic dislocation of the hip joint
- Have femoroacetabular impingement
- Have excessively mobile hip joints. e.g. young female dancers and gymnasts
- Have hip dysplasia
Dr Agolley is a hip surgeon on the Gold Coast who has a special interest in ligamentum teres injury.
What are the symptoms?
It is common for patients with LT injuries to develop pain in the groin, which may be associated with a feeling of the hip being unstable. The pain may initially be a ache, but progresses in severity and is aggravated by activities such as:
- Deep squats
- Sitting in a low chair
- Running
- Sports that require extreme movement of the hip joint such as dancing, gymnastics and martial arts
There may be a clunk or catching sensation in the hip.
What investigations will be required?
There is unfortunately no non-invasive test that can reliably diagnose ligamentum teres injury. X-rays, CT scan and MRI scan do not reliably demonstrate a LT tear. The diagnosis is often made based on the history and examination findings, and confirmed on hip arthroscopy under direct vision.
When should I have surgery?
Non-surgical treatment includes limiting hip range of motion, building up the core, and hip stabiliser muscles, and modifying training and competition routines. A good sports physician and physiotherapist who understand the pathology can help improve your symptoms. When these treatments are no longer controlling the pain, Dr Agolley will discuss your treatment options. Often hip arthroscopy is the recommended treatment to address the tear and treat the lax capsule that allows the tear to occur.
Hip Arthroscopy
Hip arthroscopy is a procedure where fibre optic technology and small arthroscopic instruments are used to access the hip joint to treat a variety of problems via minimally invasive keyhole access.