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The Asymmetric Profile of the Acetabulum

  • Original Article
  • Hip
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Despite the curvaceous profile of the acetabulum, orthopaedic surgeons have continued to implant hemispheric cups since the introduction of total hip arthroplasty. The geometric discrepancies between the natural acetabulum and implant can result in painful iliopsoas impingement attributable to prosthetic overlap at the anterior acetabular ridge over which the iliopsoas tendon extends to leave the pelvis. We expanded on previous in vitro observations of acetabular morphology using a large in vivo sample and quantified the dimensions of the psoas valley. We studied computed tomographic scans of 200 healthy hips from 50 men and 50 women. The acetabular ridges were digitized on three-dimensional bone reconstructions and their coordinates were manipulated in spreadsheets to deduce acetabular diameter, anteversion, and inclination and to plot the rim profile. Our results confirm the acetabular rim is an asymmetric succession of three peaks and three troughs. The psoas valley has the following shape distribution: 79% curved, 11% angular, 10% irregular, and 0% straight. The mean depth of the psoas valley is 5 mm and the latitude of its trough is on average 6 mm below the acetabular equator. The use of side-specific cups that replicate the curvaceous acetabular profile could prevent prosthetic overlap and reduce the incidence of iliopsoas impingement.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hôpital Européen Georges Pompidou, Paris, France

    Eric Vandenbussche MD, PhD

  2. Centre for Health Management, Imperial College London, Exhibition Road, London, SW7 2AZ, UK

    Mohammed Saffarini MEng

  3. Department of Radiology, Hôpital Européen Georges Pompidou, Paris, France

    Fabienne Taillieu MD & Céline Mutschler MD

Authors
  1. Eric Vandenbussche MD, PhD
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  2. Mohammed Saffarini MEng
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  3. Fabienne Taillieu MD
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  4. Céline Mutschler MD
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Corresponding author

Correspondence to Mohammed Saffarini MEng.

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Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Vandenbussche, E., Saffarini, M., Taillieu, F. et al. The Asymmetric Profile of the Acetabulum. Clin Orthop Relat Res 466, 417–423 (2008). https://doi.org/10.1007/s11999-007-0062-x

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  • DOI: https://doi.org/10.1007/s11999-007-0062-x

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