# Histological Structure and Immunohistochemical Properties of the Ligamentum Teres in Patients With Developmental Dysplasia of the Hip

## TL;DR

This study examines the tissue structure and protein markers in the hip ligament of patients with hip dysplasia, finding consistent inflammation and protein correlations.

## Contribution

The study identifies consistent histological changes and positive correlations between specific matrix proteins and ligament structure in DDH patients.

## Key findings

- Ligamentum teres in DDH patients shows moderate inflammation, fibrosis, and fatty infiltration.
- MMP-2, MMP-9, and ADAMTS-7 correlate positively with histological parameters.
- Findings are consistent regardless of age or radiological stage.

## Abstract

Introduction

This study aims to evaluate the histology of the ligamentum teres and its relationship with matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), which are involved in the destruction of extracellular matrix proteins in patients with developmental dysplasia of the hip (DDH).

Methodology

The patients who underwent open reduction and pelvic osteotomy due to DDH were included in the study. Patient groups were formed according to Tönnis stages, positive family history, consanguineous marriage, age, and bilateral involvement. The histology and immunohistochemical properties (MMP-2, MMP-9, and ADAMTS-7) of ligamentum teres tissue obtained from the patients were evaluated according to these groups.

Results

Thirty-five patients (female 30, 85.7%; male 5, 14.3%) with DDH between the ages of 14 and 99 months were included in the study. Preoperative and postoperative Tönnis stages, positive family history, consanguineous marriage, age, and bilaterality did not cause a significant difference between histological parameters. A significant correlation was found between MMP-2, MMP-9, and ADAMTS-7 and all histological parameters.

Conclusions

The histological structure of ligamentum teres in patients with DDH shows moderate inflammation, fibrosis, neovascularization, hyalinization, and fatty infiltration regardless of age and radiological stage. ADAMTS-7, MMP-2, and MMP-9 correlate positively with the histological parameters of the ligamentum teres in patients with DDH.