Advances in hip arthroscopy have renewed interest in the ligamentum teres. Considered by many to be a developmental vestige, it is now recognised as a significant potential source of pain and mechanical symptoms arising from the hip joint. Despite improvements in imaging, arthroscopy remains the optimum method of diagnosing lesions of the ligamentum teres. Several biological or mechanical roles have been proposed for the ligament. Unless these are disproved, the use of surgical procedures that sacrifice the ligamentum teres, as in surgical dislocation of the hip, should be carefully considered. This paper provides an update on the development, structure and function of the ligamentum teres, and discusses associated clinical implications.
In an adult man the mean femoral anteversion angle measures approximately 15°, for which the reasons have never been fully elucidated. An assortment of simian and quadruped mammalian femora was therefore examined and the anteversion angles measured. A simple static mathematical model was then produced to explain the forces acting on the neck of the femur in the quadruped and in man. Femoral anteversion was present in all the simian and quadruped femora and ranged between 4° and 41°. It thus appears that man has retained this feature despite evolving from quadrupedal locomotion. Quadrupeds generally mobilise with their