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Anatomical landmarks for acetabular abduction in adult hips: the teardrop vs. the inferior acetabular rim

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Abstract

Purpose

The purpose of this study is to compare the acetabular teardrop (the structure located inferomedially in the acetabulum, just superior to the obturator foramen. The medial lip is the interior, and the lateral lip is the exterior of the acetabular wall) with the inferior acetabular rim as anatomical landmarks to measure the acetabular abduction angle (AAD) using coronal CT images from different levels.

Methods

Our retrospective study included 120 pelvic CT scans from patients with non-orthopedic pathologies or stress fractures of the proximal femur. The patients included 60 females with a mean age of 48 years (range 40–66) and 60 males with a mean age of 46 years (range 38–65). Each AAD was measured using coronal plane CT slices from five levels: AAD (+ 10) (10 mm anterior to the femoral head center), AAD (+ 5) (5 mm anterior to the femoral head center), AAD (0) (through the femoral head center), AAD (− 5) (5 mm posterior to the femoral head center), and AAD (− 10) (10 mm posterior to the femoral head center). The measurements were then divided into two groups: teardrop-based AADs [AAD (+ 10), AAD (+ 5), and AAD (0)] and rim-based AADs [AAD (− 5) and AAD (− 10)].

Results

There were no mean significant differences in AAD within the groups, whereas the difference between the groups was significant. The mean teardrop-based AAD was quite significantly different from the mean rim-based AAD due to the use of different anatomical landmarks. Teardrop-based AADs are lower than rim-based AADs, leading to measurement differences of more than 10°.

Conclusions

AAD measurements considering the inferior acetabular rim can be more accurate than those considering the acetabular teardrop because the inferior rim represents the nearly hemispheric acetabulum better than does the teardrop. It is recommended to differentiate between the teardrop and the inferior acetabular rim when measuring AAD to avoid confusion regarding acetabular abduction.

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Author notes

  1. Jin Park and Gab Lae Kim contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, College of Medicine, Kangdong Sacred Heart Hospital, Hallym University, 150 Sung-an-ro, Kangdonggu, Seoul, 05355, South Korea

    Jin Park & Gab Lae Kim

  2. Department of Orthopedic Surgery, College of Medicine, Yonsei University, Seoul, South Korea

    Kyu Hyun Yang

Authors
  1. Jin Park
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  2. Gab Lae Kim
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  3. Kyu Hyun Yang
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Contributions

JP: project development, data collection, data analysis, manuscript writing. GLK: data collection, data analysis, manuscript writing. KHY: project development, data analysis.

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Correspondence to Jin Park.

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Park, J., Kim, G.L. & Yang, K.H. Anatomical landmarks for acetabular abduction in adult hips: the teardrop vs. the inferior acetabular rim. Surg Radiol Anat 41, 1505–1511 (2019). https://doi.org/10.1007/s00276-019-02329-1

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  • DOI: https://doi.org/10.1007/s00276-019-02329-1

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