Ligamentum Teres Reconstruction With Tibialis Anterior Allograft: Case Series With 2-Year Follow Up

Ligamentum Teres Reconstruction With Tibialis Anterior Allograft: Case Series With 2-Year Follow Up

Benjamin G. Domb, MD, UNITED STATES Elizabeth G. Walsh, BS, UNITED STATES Matthew J. Strok, BA, UNITED STATES Ady Haim Kahana Rojkind, MD, UNITED STATES Roger Quesada Jimenez, MD, UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES


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Anatomic Location

Anatomic Structure


Summary: Arthroscopic ligamentum teres reconstruction with a tibialis anterior allograft, concomitant with labral repairs and osteoplasties for FAI, have shown favorable outcomes.


Purpose

To evaluate the outcomes of ligamentum teres (LT) reconstruction with tibialis anterior allograft treatment for LT tears, with a minimum 2-year follow-up.

Methods

Data was retrospectively analyzed for all patients who underwent arthroscopic LT reconstruction with a tibialis anterior allograft between 2014-2021. Included patients had completed preoperative and minimum of 2-year postoperative questionnaires for the following patient-reported outcome (PRO) measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12),Visual Analogue Scale (VAS) for pain and patient satisfaction; or had a documented endpoint within the study's timeframe.  The MCID was calculated for the mentioned PROs and included in the analysis.

Results

A total of 22 patients were included in the study. Significant improvement was shown in mHHS, NAHS, HOS-SSS, iHOT-12, and VAS pain scale. A high patient satisfaction score was also observed at the latest follow-up. Furthermore, a high percentage of patients reached the calculated MCID for mHHS, NAHS, HOS-SSS, and VAS.

Conclusion

Arthroscopic LT reconstruction with a tibialis anterior allograft, concomitant with labral repairs and osteoplasties for FAI, have shown favorable outcomes, high patient satisfaction rates, and a high percentage of patients reaching clinically important thresholds, with a low rate of complications and THA conversion at a minimum 2-year follow-up. Furthermore, the choice of a graft rests in the hands of the surgeon, based on training, familiarity, circumstances, and resources.