Partial ligamentum teres tears are associated with larger acetabular labra and less damage to the labrum than complete ligamentum teres tears
Abstract
The purpose of this study was to investigate the association between ligamentum teres (LT) tears with hypertrophy of the acetabular labrum and cartilage and labral damage. Surgeries (1723) were performed from February 2010 to March 2016 with arthroscopic measurement of the labrum and assessment of the LT, labrum and acetabular cartilage. Labral width was measured in the anterosuperior (AS), anteroinferior (AI), posteroinferior (PI) and posterosuperior (PS) quadrants. Grade 2 (50-99% torn) LT tears had larger labra in all four quadrants (AS = 5.64 ± 1.97 mm; AI = 5.23 ± 1.51; PS = 5.58 ± 1.39; PI = 4.60 ± 1.13) than grade 3 (100% torn) (AS = 5.50 ± 1.94; AI 4.90 ± 1.43; PS 5.43 ± 1.32; PI 4.42 ± 1.03), grade 1 (<50% torn) (AS 5.30 ± 1.68; AI 4.96 ± 1.32; PS = 5.38 ± 1.13; PI = 4.45 ± 1.04) and no tear (AS = 5.09 ± 1.51; AI = 4.92 ± 1.24; PS = 5.24 ± 1.09; PI = 4.37 ± .93); P < 0.01 in all quadrants. Grade 3 LT tears had more damage to the labrum than grade 2, grade 1 and no tear; P < 0.001. ALAD tears were larger in grade 3 and grade 2 than grade 1 and non-torn LTs; P < 0.001. Grade 3 tears had a higher percentage of high-grade cartilage tears than grade 2 LT tears; P < 0.001. Degenerative tears had larger labra, labral tears and acetabular cartilage tears than full- and partial-thickness LT tears; P < 0.01. Patients with partial-thickness LT tears had larger labra in all four quadrants than full-thickness tears in the Percentile and Villar classifications. Full-thickness tears had more severe labral damage and higher-grade chondral damage than partial-thickness tears. Degenerative tears demonstrated the largest labra, labral tears and ALAD tears. The condition of the LT demonstrated an association with acetabular cartilage injury and should be evaluated when considering hip preservation surgery. LEVEL OF EVIDENCE: Level IV Case Series.