What is the foveal artery of the hip, its origin, and its role in preventing avascular necrosis of the femoral head? | Rounds What is the foveal artery of the hip, its origin, and its role in preventing avascular necrosis of the femoral head? | Rounds
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What is the foveal artery of the hip, its origin, and its role in preventing avascular necrosis of the femoral head?

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Foveal artery of the hip

The foveal artery (also termed the ligamentum teres artery or artery of the fovea capitis) is the small arterial channel located within the ligament of the head of the femur (ligamentum teres) that courses to the fovea capitis femoris. [1] It contributes to perfusion of the femoral head through the intraosseous arterial network accessed via the fovea. [2]

Anatomic origin

The ligamentum teres artery originates from the posterior division of the obturator artery and attaches to the fovea capitis femoris. [1]

Entry into the femoral head

The round ligament arterial (ligamentum teres) system enters the femoral head through the fovea and joins the epiphyseal arterial network. [2]

Role in maintaining perfusion of the femoral head

The femoral head receives blood from multiple sources, with primary inflow through retinacular arteries and additional contribution via the round ligament arterial group that enters through the fovea. [2] Because the round ligament arterial supply reaches the femoral head via the fovea, disruption of the ligamentum teres vessels can reduce local perfusion when other femoral head blood supplies are compromised. [2]

Relevance to avascular necrosis risk

Avascular necrosis of the femoral head is driven by failure of femoral head blood supply to meet metabolic needs. [3] In specific settings, such as femoral neck fractures or events that disrupt the ligamentum teres vascular pathway, perfusion through the foveal (ligamentum teres) artery becomes clinically relevant because it represents a direct pathway of arterial inflow to the femoral head through the fovea. [2]

Practical clinical implication

Femoral head perfusion depends on preserving femoral head arterial pathways, including those that traverse the ligamentum teres and enter via the fovea. [3] Damage to femoral head blood supply, including pathways associated with the foveal artery, is a mechanism linked to development of osteonecrosis. [3]

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