EP1.8 Hip microinstability in the absence of dysplasia: Treatment with Ligamentum Teres reconstruction and capsulolabral stabilisation

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ID: 331029
2026
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Abstract
Abstract Introduction Multiple factors dictate hip joint stability including osseous anatomy, ligaments, hip capsule and musculature. Ligamentum Teres (LT) provides biomechanical, proprioceptive and nociceptive function thus potentially contributing to hip joint stability including resistance to external rotation torque. Additional soft tissue entities including capsular ligaments in particular iliofemoral ligament, and labrum contribute. Aims To assess the efficacy of hip instability treatment with soft tissue repair and reconstruction including LT reconstruction, Capsular plication and labral repair or reconstruction. Materials and Methods Prospective cohort study of patients with symptomatic hip instability who had failed previous treatment. Osseous anatomy was screening to rule out dysplasia. Patients including hypermobility spectrum were included. Null hypothesis was that soft tissue reconstruction does not make a difference to functional outcome in patients with hip instability. Patients with rupture of LT (Villar and Gray Grade-1) or incompetent LT, significant labral tear or irreparable labrum and capsular laxity of deficiency were included. Patients with Tonnis grade 2-3 osteoarthritis, center-edge angle <26 were excluded. Data were collected pre, per and post- operatively at 6,12,26 weeks and then annually. It included radiographic features, associated injuries, Beighton score, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS) and visual analogue score (VAS) for satisfaction (0-10, 10=very satisfied). Single sample t-test for continuous variables was employed. Regression model was built to test for effect of co-variates. Adverse events were recorded. Results There were 83 patients with mean age of 35.2 years (19, 54). Mean follow-up was 60 months. There were 19 cases of LT reconstruction, 13 labral reconstruction and 47 with capsular plication and 3 cases of iliofemoral repair. The mean improvement in preoperative scores following hip arthroscopy for soft tissue related instability; mHHS from 60 to 89 (p<0.05), VAS from 5.7 (median 6) to 9 (median 9), NAHS from 62 to 88 (p<0.03)). Redo hip arthroscopy was required in 2/56. None of the patients had graft rejection, infection or conversion to hip replacement. Conclusion The medium term results of multiple soft tissue reconstructions addressing LT, labrum and capsular entity appear to address hip instability and results are sustained at 5 years.
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Authors Ali S. Bajwa
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.192
URL
https://doi.org/10.1093/jhps/hnag043.192
Keywords Keywords not found

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