Hip stability after ligamentum teres resection during surgical dislocation for cam impingement.

Abstract

The purpose of this study was to investigate whether patients who have undergone surgical hip dislocation with excision of the ligamentum teres exhibited symptoms of a Type I ligamentum teres rupture. A questionnaire was designed to enquire about specific symptoms attributed to Type I injuries (complete rupture) in the literature: gross instability, incomplete reduction, inability to bear weight and mechanical symptoms. 217 consecutive patients were surveyed and 161 patients (75%) returned 168 questionnaires (75%). Mean age was 34 and median follow-up was 51 months (35 to 97). All patients were able to fully weight bear after surgery while 77% experienced no groin pain and 61% experienced no pain on exercise. 35% of patients experienced popping and locking in their operated hip and 24% had subjective feeling of their hip giving way. Patients who have had surgical excision of the ligamentum teres during open osteochondroplasty for cam deformities do not exhibit symptoms of a Type I ligamentum teres rupture. Our results show that minor instability symptoms may be present but symptoms present more like to Type II (partial) injuries. We propose that Type II injuries be divided into Type IIa; partial tear and Type IIb; iatrogenic rupture.