Ligamentum Teres Tears

What are ligamentum teres tears?

The ligamentum teres is a cord-like structure that connects the femoral head to the acetabulum within the hip joint.

The hip is a ball-and-socket joint formed by the femoral head (ball) and the acetabulum (socket). The ligamentum teres sits deep in the joint and contributes to hip stability.

Tears of the ligamentum teres often occur alongside other hip conditions such as femoroacetabular impingement (FAI) and labral tears, and are relatively common in dancers and gymnasts.

Diagnosis can be challenging: routine MRI may miss these tears. Fortunately, they can be diagnosed and treated during a hip arthroscopy.

What are the symptoms of a ligamentum teres tear?

Groin pain is the most frequent symptom. Initially, discomfort may be felt only during sport—particularly dancing or gymnastics. Over time, pain may occur with movements that draw the knees toward the chest, including:

• Sitting in low chairs
• Getting up from a chair
• Driving
• Putting on socks and shoes
• Picking items up from the ground
• Climbing stairs

In athletes such as dancers or gymnasts, hip movements may feel restricted or unstable.

Causes of ligamentum teres tears

• Hip dislocation: High-energy trauma that dislocates the hip typically tears the ligamentum teres.
• Femoroacetabular impingement (FAI): LT tears commonly coexist with FAI.
• Sports and activities: Repetitive end-range motion and flexibility demands in dancing and gymnastics increase risk.

Risk factors for ligamentum teres tears

• FAI: Frequently associated; both issues are often addressed during hip arthroscopy.
• Dancers and gymnasts: High flexibility and extreme ranges of motion place additional stress on the ligament.

Investigations to diagnose ligamentum teres tears

No single investigation reliably confirms an LT tear in every case. Diagnosis is based on a combination of history, examination, and imaging.

• X-ray/CT/MRI: May appear normal or fail to detect a tear.
• Diagnostic hip injection: Relief after an intra-articular local anaesthetic/corticosteroid injection suggests the hip joint as the pain source.
• Hip arthroscopy: The definitive method to directly assess and treat the ligament.

Complications and associated findings

Ligamentum teres tears are often accompanied by synovitis (capsulitis) and intra-articular inflammation, causing pain with hip movement, prolonged sitting, and sometimes when lying on the side.

 

Who will be involved in your care?

Your Family Doctor (GP)

• Assess symptoms and initiate first-line management
• Prescribe appropriate medications
• Refer to specialists where needed

Sports Physician

A doctor specialising in sports injuries who can guide non-operative care, injections, and return-to-sport planning.

Physiotherapist

Hip-specific physiotherapy is important. Standard hip exercise programs may aggravate symptoms. A trained physiotherapist will tailor movements, protect the capsule, and progressively rebuild strength and control.

Orthopaedic Surgeon

An orthopaedic surgeon experienced in hip arthroscopy can confirm the diagnosis and treat the tear. If required, you may be referred to a hip arthroscopy specialist.

Treatment

During hip arthroscopy, torn and inflamed fibres are removed and the remaining ligament is debrided and stabilised, typically using a radiofrequency ablator and arthroscopic instruments. Associated issues, such as labral tears or FAI, can be addressed in the same procedure when appropriate.

Recovery after surgery

Recovery time varies with the extent of intra-articular damage and procedures performed.

• Hospital stay: Most patients go home the next morning.
• Time off work (guide): Office work ~2 weeks; manual work ~6 weeks.
• Return to activity (typical milestones):
  • ~4 weeks: Stationary cycling
  • ~6 weeks: Graduated walk-jog on a treadmill before outdoor running
• Your physiotherapist will individualise a return-to-sport plan based on healing, strength, and control.