2015 ISAKOS Biennial Congress ePoster #809
Articular Cartilage Damage in Patients With Ligamentum Teres Tear
Mitsunori Kaya, MD, Sapporo JAPAN
Tomoyuki Suzuki, MD, PhD, Sapporo, Hokkaido JAPAN
Toshihiko Yamashita, MD, PhD, Sapporo, Hokkaido JAPAN
Department of Orthopaedic Surgery, Sapporo Medical University, Sapporo, Hokkaido, JAPAN
FDA Status Not Applicable
Summary: Ligamentum teres injury may predispose the hip to degenerative arthritis.
In the current manuscript, we have analyzed that articular cartilage damage between the ligamentum teres-intact and -ruptured hip to investigate the effect of ligamentum teres injury on hip joint cartilage damage in patients with femoroacetabular impingement. Our hypothesis was that ligamentum teres injury might alter the articular cartilage damage pattern in patients with femoroacetabular impingement.
We compared the articular cartilage damage between ligamentum teres-intact and -ruptured hips. Data were collected for 77 consecutive patients with femoroacetabular impingement who underwent hip arthroscopy. The chondral lesions were recorded on anatomic articular maps using the geographic zone method. The depths of cartilage defects were classified according to the International Society for Cartilage Repair grading system. The patients were divided into two groups (ligamentum teres-intact and -injured groups) and the incidence and degree of cartilage injury were compared between the two groups using the Mann-Whitney U test. Differences were deemed statistically significant at p<0.05. Statistical analysis was performed with the Statistical Package for Social Science 9.0 version (SPSS Inc. Chicago, Illinois).
The patient population consisted of 32 male and 45 female patients with a mean age of 47.5 years (range, 18-78 years). According to the Gray and Villar classification, 20 patients had a complete rupture and 27 had a partial tear. These patients were divided into two groups (ligamentum teres-intact group; n=30, ligamentum teres-injured group; n=47).
In patients with ligamentum teres injury, chondral damage extended to the middle inferior area of the acetabulum [7.6 % (grade 1) in the ligamentum teres-intact group, 66.6 % (grade 1; 12.1%, grade 2; 42.4%, grade 3; 12.1%) in the ligamentum teres-injured group, p<0.01] and the apex of the femoral head [anterior apex: 7.1% (grade 1; 3.8%, grade 2; 3.3%) in the intact group and 42.4% (grade 1; 30.3%, grade 2; 12.1%) in the injured group, p<0.01; middle apex: 7.6% (grade 1; 3.8%, grade 2; 3.8%) in the intact group and 63.5% (grade 1; 42.4%, grade 2; 18.15, grade 3; 3.0%) in the injured group, p=0.04; posterior apex: 7.6% (grade 1; 3.8%, grade 2; 3.8%) in the intact group and 42.4% ( grade 1; 30.3%, grade 2; 12.1%) in the injured group, p<0.01].
We compared the cartilage damage patterns between the ligamentum teres-intact and -injured hips to investigate the effect of ligamentum teres injury on hip joint cartilage damage. The most important finding of our study was that ligamentum teres injury was strongly associated with articular cartilage damage in the inferior middle part of the acetabulum and the apex of the femoral head in addition to FAI-specific chondral damage. The scenario that ligamentum teres tears lead to instability and instability of the hip joint lead to articular cartilage damage is assumed. These data suggest the possibility that ligamentum teres injury may predispose the hip to degenerative arthritis.