Ligamentum Teres Tears

What is a Ligamentum Teres Tear?

The ligamentum teres (LT) is a cord-like structure stemming from the acetabulum (socket) and attaching to the femoral head (ball) of the hip. This structure is responsible for providing stability to the hip joint. When someone has hip pain, the ligamentum teres is often one of the structures assessed for structural integrity. Patients struggling with LT tears may have hip dislocations, feeling as if their hip is giving out, and overall instability in the hip.

Causes of Ligamentum Teres of Tears

Ligamentum teres tears are believed to be caused by a mixture of patient-specific factors, such as activity level, musculoskeletal stability, aging, Ehlers Danlos Syndrome, and other loose ligament syndromes. Athletes who engage in frequent physical activity may put the structures of the hip in straining positions and damage LT over time. Patients lacking structural integrity surrounding the hip can be prone to placing harmful stress on the LT. Additionally, as patients age, the LT can degenerate through wear and tear. Tears of the LT can be associated with other painful conditions:

Hip dysplasia
Muscular instability
Hypermobility
Muscular imbalances
Aging

Symptoms of Ligamentum Teres of Tears

Symptoms of ligamentum teres tears, and can include:

Giving out of the hip
Weakness in the hip
Irritation after physical activity
Apprehension to move the leg in extreme ranges of motion

Diagnosis of Ligamentum Teres Tears

LT tears in the hip can be diagnosed with numerous clinical tools. There are a variety of tests that help clinicians determine a correct diagnosis and an effective treatment plan. Your doctor will carefully review your symptoms, medical history, and perform a physical examination. Diagnostic tests for LT tears:

Physical Exam: A series of movements can be used to assess the stability of the hip and suggest damage to stabilizing structures such as the LT.

MRI Scan: This study uses a large magnetic field and radio waves to produce images that help in detecting damage to soft tissue. MRI images can show evidence of LT tears.

CT Scan: This scan uses multiple X-rays to produce detailed cross-section images of soft tissues, bone, and cartilage structures.

X-rays: This study uses electromagnetic beams to identify the presence of stress fractures or bony deformities within the hip.

Treatment for Ligamenum Teres Tears

Treatment for LT tears are based on anatomical considerations, patient-specific needs, and symptoms. Your doctor may initially recommend conservative treatment to help relieve the symptoms. This may be sufficient for mild cases of LT tears.

Conservative Treatments

Anti-inflammatory medication: Your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation in the tissues.

Rest and Activity Modification: Reducing or modifying physical activity can provide the LT the time needed to heal.

Injections: Your doctor may recommend steroid injections or orthobiologic injections to reduce pain and promote healing of the LT.

Physical therapy: Exercises and stretches that improve balance and stability can mitigate the symptoms of LT tears.

Surgical Treatment

If conservative treatment methods are ineffective, and if the patient and physician feel necessary, surgical treatment can be recommended. Below are possible surgical interventions for LT tears:

Ligamentum teres debridement
Ligamentum teres reconstruction
Capsular repair, reconstruction, or plication of the hip

Depending on operative findings and procedures performed, rehabilitation from surgery can take several weeks to several months.