Biomechanic Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.; Department of Orthopaedic Surgery, Chosun University School of Medicine, Gwangju, Republic of Korea.
Biomechanic Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Arthroscopy. 2018 May;34(5):1480-1487. doi: 10.1016/j.arthro.2017.12.002. Epub 2018 Feb 1.
To determine the contribution of the ligamentum teres (LT) to hip stability in the presence of an intact capsule with special attention to the change in range of motion and femoral head translation.
Seven fresh-frozen cadaveric pelvises were used. Following visual inspection of the LT at different hip positions, internal rotation angles were measured at 10° of extension and at 0° of flexion, while external rotation was measured at 60°, 90°, and 110° of flexion with different hip abduction angles using electromagnetic motion tracking sensor. Femoral head translations were measured simultaneously. The tests were repeated after resection of the LT. The capsule was left intact for all test conditions. The results were compared between intact and LT resected conditions when torque of 2 and 4 Nm was applied.
Compared with the intact hip, the LT resected hip showed no significant difference when 2 Nm torque was applied in all scenarios. With 4 Nm torque application, significant increase in external rotation was found at 60° and at 90° of flexion (1.7° ± 0.8° and 2.1° ± 1.0°, respectively). Significant difference was also noted at 60°, 90°, and 110° of flexion when the hip was in the adducted position while at 90° in the abducted hip. However, LT resection did not show significant change in internal rotation. There was no significant difference in the translation distance of the femoral head in the intact hip compared with the LT resected hip (0.77-1.11 mm vs 0.79-1.29 mm).
Our results indicate that within the physiologic range of motion, LT can minimally limit external rotation when the hip is in the flexed position but does not contribute to translation stability.
In the hip with intact capsule, LT deficiency can result in a slight increase in range of motion, but its contribution to stability is questionable.
研究在完整关节囊的情况下，圆韧带（LT）对髋关节稳定性的贡献，特别关注运动范围和股骨头移位的变化。
使用 7 个新鲜冷冻的骨盆标本。在不同髋关节位置观察 LT 后，在 10°伸展位和 0°屈曲位测量内旋角度，同时在外展角为 0°、60°、90°和 110°时测量外旋角度，使用电磁运动跟踪传感器。同时测量股骨头移位。切除 LT 后重复测试。所有测试条件下关节囊均保持完整。当施加 2 和 4 Nm 的扭矩时，比较完整和 LT 切除条件下的结果。
与完整髋关节相比，当施加 2 Nm 扭矩时，在所有情况下，切除 LT 的髋关节没有显著差异。当施加 4 Nm 扭矩时，在 60°和 90°屈曲时，外旋明显增加（分别为 1.7°±0.8°和 2.1°±1.0°）。在髋关节内收时，在 60°、90°和 110°屈曲时，以及在髋关节外展时 90°屈曲时，也有显著差异。然而，LT 切除对内旋没有明显变化。在完整髋关节与 LT 切除髋关节相比，股骨头的移位距离没有显著差异（0.77-1.11mm 比 0.79-1.29mm）。
我们的结果表明，在生理运动范围内，LT 可以最小程度地限制髋关节屈曲时的外旋，但对稳定性没有贡献。
在完整关节囊的髋关节中，LT 缺陷可能导致运动范围略有增加，但对稳定性的贡献值得怀疑。
