Open surgical dislocation versus arthroscopy for femoroacetabular impingement: a comparison of clinical outcomes
Authors
Botser IB, Martin DE, Stout CE, Domb BG
DOI: 10.1177/0363546511413865
Purpose
To evaluate how often ligamentum teres (LT) tears are found during hip arthroscopy and categorize them using both an established and a new descriptive classification system.
Methods
558 hip arthroscopies (502 patients) were reviewed. LT tears were classified by both Gray and Villar's system and a new descriptive scale (grades 0–3). Preoperative symptoms, MRI results, and intraoperative findings were analyzed.
Key Findings
- LT tears were present in 51% of cases.
- By descriptive grading: 22% were grade 1 (<50% tear), 24% grade 2 (>50%), 5% grade 3 (complete tear).
- LT tears were associated with older age, worse function, more labral damage, and increased hip motion.
- MRI was not reliable in detecting LT tears.
- No correlation found between LT tears and reported pain levels.
Conclusion
LT tears are more common than previously reported and are often underdiagnosed due to low MRI sensitivity. They correlate with functional limitations and joint damage.
What this means for patients
If you’re undergoing hip arthroscopy, your surgeon may find and treat tears in the ligamentum teres that MRIs often miss. These tears may affect your mobility and hip function, even if pain isn’t severe.