Journal article
Ligamentum Teres Transfer During Medial Open Reduction in Patients with Developmental Dysplasia of the Hip
The Iowa orthopaedic journal, Vol.41(1), pp.47-53
2021
PMCID: PMC8259203
PMID: 34552403
Appears in Diamond Open Access
Abstract
The ligamentum teres (LT) is believed to have a number of functions, including a role in hip stability, nociception, proprioception, vascular supply to the femoral head, and synovial fluid circulation. The LT is often excised in the process of performing a medial open reduction (MOR) of the hip. We sought to conduct a retrospective review of hips undergoing a MOR for dislocated infantile developmental dysplasia of the hip (DDH) to compare clinical and radiographic outcomes for patients with and without LT reconstruction.
We performed a retrospective review of 38 hips treated with MOR with or without LT reconstruction with minimum two-year follow-up. Radiographic outcomes were determined using the Severin score. Information regarding avascular necrosis (AVN), concomitant surgical procedures, repeat dislocation, subsequent surgery, limp, pain, and range of motion symmetry was recorded.
Eighteen hips that underwent MOR with LT reconstruction were compared to 20 hips that underwent MOR without LT reconstruction. Mean follow up for this cohort was 70.1 months (median: 61.8; Range: 24.2 to 182.2 months). The group with LT reconstruction had an 11% rate of AVN, the group without LT reconstruction had a 15% rate of AVN (p=1.0) No hips in either group re-dislocated or had pain at final follow up. Two hips (5%) had a limp at most recent follow up, all were in the group that did not receive a LT reconstruction (p=0.488). Three hips (17%) in the LT reconstruction group and one hip (5%) in the other group had asymmetrical hip range of motion at final follow up (p=0.328).
This study offers preliminary data to suggest that ligamentum teres reconstruction is a safe procedure that can minimize the risk for subluxation or re-dislocation that can occur within the post reduction hip spica cast. Although in this study, the patients who did not have LT reconstruction had a similar re-dislocation rate, we believe that ligamentum teres preservation is a useful adjunct to medial open reduction, especially in centers that may only treat occasional cases or have less experience in applying an excellent hip spica cast.
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Details
- Title: Subtitle
- Ligamentum Teres Transfer During Medial Open Reduction in Patients with Developmental Dysplasia of the Hip
- Creators
- Conner Paez - University of California San Diego School of Medicine, La Jolla, CA, USARaghav Badrinath - Rady Children's Hospital, San Diego, CA, USAJoshua Holt - University of IowaJames D Bomar - Rady Children's Hospital, San Diego, CA, USAScott J Mubarak - Rady Children's Hospital, San Diego, CA, USAVidyadhar V Upasani - Rady Children's Hospital, San Diego, CA, USADennis R Wenger - Rady Children's Hospital, San Diego, CA, USA
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.41(1), pp.47-53
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 34552403
- PMCID
- PMC8259203
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2021
- Academic Unit
- Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
- Record Identifier
- 9984306005102771
Metrics
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