TY - JOUR
T1 - Indications and Outcomes After Ligamentum Teres Reconstruction
T2 - A Systematic Review
AU - Knapik, Derrick M.
AU - Farivar, Daniel
AU - Kunze, Kyle N.
AU - Gilat, Ron
AU - Nho, Shane J.
AU - Chahla, Jorge
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: S.J.N. receives research support from Allosource, Arthrex, Athletico, DJ Orthopaedics, Linvatec, Miomed, Smith & Nephew, and Stryker; receives intellectual property royalties from Ossur and Stryker; is a paid consultant for Stryker; receives publishing royalties and financial support from Springer; and receives travel and lodging, education support, and food and beverage from Stryker. J.C. is a paid consultant for Arthrex, ConMed Linvatec, Ossur, and Smith & Nephew; received education payments from Arthrex (2018-2019) and Smith & Nephew (2018-2019); received consulting fees from DePuy Synthes Products (2019), Linvatec (2019), and Smith & Nephew (2019); received speaking fees from Linvatec (2019); and received hospitality payments from Medical Device Business Services (2019), Medwest Associates (2019), and Stryker (2019). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2021 Arthroscopy Association of North America
PY - 2021/6
Y1 - 2021/6
N2 - Purpose: To systematically review the literature to better understand the current indications for ligamentum teres reconstruction (LTR), current graft and acetabular fixation options used, patient-reported outcomes after LTR, and incidence of complications and reoperations after LTR. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. All literature related to LTR published prior to July 2020 was identified. The inclusion criteria consisted of investigations reporting on human patients with pathology of the ligamentum teres who underwent LTR, including mentions of the indications, graft type, acetabular fixation method, postoperative patient-reported outcome scores, and incidence of complications and reoperations. Results: Seven studies comprising 26 patients (28 hips) were included. The most commonly reported indication for LTR was persistent pain and instability after failed prior hip arthroscopy (68%, 19 of 28 hips). The mean postoperative modified Harris Hip Score, Non-arthritic Hip Score, and visual analog scale score all showed improvement when compared with preoperative values. A total of 2 complications occurred. Complication rates ranged from 0% to 100% in included case reports and 0% to 11% in included case series. A total of 9 reoperations were performed. Reoperation rates ranged from 0% to 100% for case reports and 18% to 100% for case series. Reoperation rates ranged from 33% to 100% in studies with patients receiving acetabular fixation using anchors versus 0% to 22% in studies performing LTR with buttons. Reoperation rates in athletic patients and patients with Ehlers-Danlos syndrome ranged from 0% to 100% and 0% to 50%, respectively. Conclusions: The main indication for LTR was persistent hip or groin pain and instability after a prior hip arthroscopy. The short-term postoperative modified Harris Hip Score, Non-arthritic Hip Score, and visual analog scale score after LTR showed favorable outcomes. However, reoperations after LTR were not uncommon. Level of Evidence: Level V, systematic review of Level IV and V studies.
AB - Purpose: To systematically review the literature to better understand the current indications for ligamentum teres reconstruction (LTR), current graft and acetabular fixation options used, patient-reported outcomes after LTR, and incidence of complications and reoperations after LTR. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. All literature related to LTR published prior to July 2020 was identified. The inclusion criteria consisted of investigations reporting on human patients with pathology of the ligamentum teres who underwent LTR, including mentions of the indications, graft type, acetabular fixation method, postoperative patient-reported outcome scores, and incidence of complications and reoperations. Results: Seven studies comprising 26 patients (28 hips) were included. The most commonly reported indication for LTR was persistent pain and instability after failed prior hip arthroscopy (68%, 19 of 28 hips). The mean postoperative modified Harris Hip Score, Non-arthritic Hip Score, and visual analog scale score all showed improvement when compared with preoperative values. A total of 2 complications occurred. Complication rates ranged from 0% to 100% in included case reports and 0% to 11% in included case series. A total of 9 reoperations were performed. Reoperation rates ranged from 0% to 100% for case reports and 18% to 100% for case series. Reoperation rates ranged from 33% to 100% in studies with patients receiving acetabular fixation using anchors versus 0% to 22% in studies performing LTR with buttons. Reoperation rates in athletic patients and patients with Ehlers-Danlos syndrome ranged from 0% to 100% and 0% to 50%, respectively. Conclusions: The main indication for LTR was persistent hip or groin pain and instability after a prior hip arthroscopy. The short-term postoperative modified Harris Hip Score, Non-arthritic Hip Score, and visual analog scale score after LTR showed favorable outcomes. However, reoperations after LTR were not uncommon. Level of Evidence: Level V, systematic review of Level IV and V studies.
UR - http://www.scopus.com/inward/record.url?scp=85114005376&partnerID=8YFLogxK
U2 - 10.1016/j.asmr.2021.01.023
DO - 10.1016/j.asmr.2021.01.023
M3 - Review article
C2 - 34195664
AN - SCOPUS:85114005376
SN - 2666-061X
VL - 3
SP - e939-e949
JO - Arthroscopy, Sports Medicine, and Rehabilitation
JF - Arthroscopy, Sports Medicine, and Rehabilitation
IS - 3
ER -