Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function.

ABSTRACT

The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed. A total of 69 references were obtained, that included 53 full text articles, three published abstracts, and 13 textbooks. Many publications related to clinical studies (n = 11) rather than gross anatomy (n = 7), with one report on variation of the LHF. Considerable inconsistency in the naming and description of the LHF morphology was observed. Variable attachment sites were reported except for the acetabular notch, transverse acetabular ligament, and the femoral fovea. Presence and patency of the ligamental arteries supplying the head of the femur and their exact location were variably described and were often incomplete. The LHF is believed to be taught in extreme hip adduction, but there is little evidence to support this. In conclusions, further investigation of the anatomy of the LHF is recommended, particularly to clarify its mechanical role, innervation, and vascular contribution to the developing and adult femur, so to better inform clinical practice.