Ligamentum teres injuries - an observational study of a proposed new arthroscopic classification.

Ligamentum teres (LT) Injuries or tears have been said to be a common cause of groin discomfort and pain, and they have been identified in 8-51% of patients undergoing hip arthroscopy. Currently, in the literature there exist three arthroscopic classifications for LT injuries and tears: the first classification was established by Gray and Villar, Botser and Domb proposed the second one which they called a descriptive classification according to the degree of partial thickness LT tears and more recently the last classification by Cerezal et al. (RadioGraphics 2010; 30:1637-51), where they take into account the one by Gray and Villar but adding an avulsion fracture and absence of the LT. We propose a new classification, which also takes into account, observed LT pathologies, as well as the possible pathological mechanism of LT tears, and offer a guide to treatment. This classification is based on direct arthroscopic observation and dynamic rotational maneuvers of the hip under distraction. This classification incorporates those pathologies, which have been observed as a result of this more focused examination of the LT.