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| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 69
| Issue : 4 | Page : 220-225 |
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Morphological and morphometric study of the acetabulum of dry human hip bone and its clinical implication in hip arthroplasty
Archana Singh1, Rakesh Gupta1, Arun Singh2
1 Department of Anatomy, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
2 Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
| Date of Submission | 06-Nov-2019 |
| Date of Acceptance | 22-May-2020 |
| Date of Web Publication | 29-Dec-2020 |
Correspondence Address:
Dr. Archana Singh
Department of Anatomy, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JASI.JASI_214_19
Introduction: The objective was to study the morphology of the acetabular margin and articular surface and to measure the various dimensions of the acetabulum in dry human hip bones. Material and Methods: A cross-sectional morphological and morphometric study was performed on 92 undamaged acetabulum of adult dry human hip bone of unknown age and gender. The shape of anterior margin of the acetabulum and shape of the anterior and posterior ends of the articular surface of the acetabulum were observed. Morphometry was done using a Vernier caliper of accuracy of 0.01 mm. Vertical diameter (VD), transverse diameter (TD), anteroposterior diameter (APD), internotch distance (ND), and depth of the acetabulum were measured. Surface area (SA) and volume (V) of the acetabulum were calculated by mathematical calculation of dome. Statistical analysis was done using SPSS software version 22.0 (IBM, SPSS statistics, UNICOM GLOBAL, California, United States). The Pearson's correlation test was used. Results: In the present study, the anterior acetabular ridge was curved in 45.7% (42), angulated in 26.17% (24), straight in 13% (12), and irregular in 13% (12) bones. The anterior end of the lunate articular surface was angulated, and the posterior end was lunate in shape in 45.7% (42), whereas in 54.3% (50), bone both the ends were lunate in shape. Morphometric values and mean ± standard deviation were as follows: 48.21 mm ± 3.31 mm (VD), 47.81 mm ± 3.37 mm (TD), 48.79 mm ± 4.08 mm (APD), 23.58 mm ± 2.77 mm (ND), 27.45 mm ± 3.02 mm (D), 4162.56 mm2 ± 755.58 (SA), and 36,563.65 mm3 ± 9408.67 (V). Discussion and Conclusion: The knowledge of these acetabular parameters is necessary for the creation of acetabular prosthesis and surgical procedures such as acetabular reconstruction in hip joint surgeries.
Keywords: Acetabular prosthesis, acetabulum, lunate articular surface
How to cite this article:
Singh A, Gupta R, Singh A. Morphological and morphometric study of the acetabulum of dry human hip bone and its clinical implication in hip arthroplasty. J Anat Soc India 2020;69:220-5 |
How to cite this URL:
Singh A, Gupta R, Singh A. Morphological and morphometric study of the acetabulum of dry human hip bone and its clinical implication in hip arthroplasty. J Anat Soc India [serial online] 2020 [cited 2023 Jan 27];69:220-5. Available from: https://www.jasi.org.in/text.asp?2020/69/4/220/305374 |
| Introduction | |  |
The acetabulum is a cup-shaped cavity present on the lateral side of the hip bone. In Latin, the meaning of the acetabulum is a shallow vinegar cup.[1] Acetabulum articulates with the head of the femur to form the hip joint which is a ball-and-socket variety of synovial joint. The acetabulum has a lunate articular surface and a nonarticular fossa on the center of the floor of the acetabulum. The lunate articular surface is covered by hyaline cartilage, and the acetabular fossa is filled with fibroelastic fat and covered with the synovial membrane. All the three bones such as ileum, ischium, and pubis contribute to form the acetabulum. The pubis forms the anterior one-fifth, the ileum forms posterosuperior two-fifth, and the ischium forms posteroinferior two-fifth of the acetabulum. The articular surface is deficient inferiorly, known as the acetabular notch, and is bridged by transverse acetabular ligament. The depth of acetabulum (DH) is increased by the attachment of fibrocartilaginous rim known as acetabulum labrum. It holds the femoral head and maintains the joint stability.[2]
Anterior acetabular ridge's morphology is helpful in the diagnosis of congenital acetabular dysplasia and during acetabular surgeries. Previous studies evaluate the anterior acetabular ridge morphology.[3],[4],[5]
The diameters and DH are valuable for surgical treatments like total hip arthroplasty. It will also helpful to the anthropologist in determining the gender, and it is also enlightening to the radiologist and prosthetist. According to Kulkarni,[6] the acetabulum is divided into three zones to find the degree of slacking of the acetabulum.
Because of variation in the shape of the acetabulum, the joint congruencies are much frequent even with minor anatomical variations.[7] Incongruencies of joint may be prone to the degenerative changes in comparison to the normal joint anatomy.[8]
Aims and objectives
Aim
The aim was to know the morphological features of the acetabulum and to measure various dimensions of the acetabulum in dry human hip bone.
Objectives
To observe the shape of anterior margin and lunate articular surface of the acetabulum, to measure the various parameters and to calculate the surface area (SA) and volume (V) of acetabulum. To find the correlation between depth and V and depth and SA of acetabulum.
| Material and Methods | | |
This cross-sectional study was conducted after getting the permission from the institutional ethics committee. A total of 92 dry adult human hip bones of unknown gender were taken from the Department of Anatomy of Medical College of Uttar Pradesh. The following morphological and morphometric parameters were recorded.
Morphological features were as follows:
- Anterior acetabular ridge: [9] the shape of ridge was evaluated and classified as curved, straight, angular, and irregular
- Ends of lunate surface: [9] the shape of anterior and posterior ends of the lunate surface was noted as curved or angular (pointed).
Morphometric parameters were as follows: measured by a digital Vernier caliper in millimeters [Figure 1] and [Figure 2]. | Figure 1: Morphometric measurements of the acetabulum; (A) vertical diameter, (B) transverse diameter, (C) anteroposterior diameter
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 | Figure 2: Measurements related to the surface area and volume of the acetabulum; h = depth of articular surface = radius of articular surface, R = radius of hemisphere
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- Vertical diameters (VDs): farthest distance on the acetabular margin in vertical plane (at the line from the anterior superior iliac spine to the most prominent point on the ischial tuberosity)[10]
- Transverse diameters (TD): farthest distance on acetabular rim in horizontal plane[10]
- Anteroposterior diameter (APD): farthest distance on acetabular rim in anteroposterior axis[10]
- DH: thin metallic scale was placed across the acetabulum. With the help of sliding Vernier caliper, the depth was measured[10]
- Width of acetabular notch distance (ND): distance between the two ends of lunate articular surface.
- SA and V: measurement of SA and V of acetabular cavity was challenging. SA and V were calculated by mathematical formulas for dome.
Mathematical calculations of a dome (the hemispherical concavity of the radial head) are as follows: [Figure 2].
Formulas:[11] SA = π (h2) + r2)
v = 1/6πh (3r2 + h2)
| Results | | |
Out of the total 92 hip bones, 42 were of the right side and 50 were of the left side. The acetabular anterior margin was found to be curved in 45.7% (57.1% in the right side and 36% in the left side), angulated in 26.1% (23.8% in the right side and 28% in the left side), straight in 15.2% bones (14.3% in the right side and 16% in the left side), and irregular in 13% acetabulum (4.8% in the right side and 20% in the left side) [Figure 3]. The anterior end of the articular margin was angulated in 45.7% of acetabulum and lunate in 54.3% of bones. The posterior end of the articular margin of the acetabulum was lunate in shape in all the acetabulum [Table 1] and [Figure 4]. | Figure 3: Shape of the anterior acetabular margin; (a) curved, (b) angular, (c) straight, (d) irregular
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 | Table 1: Different shapes of the anterior margin of the acetabulum and shape of ends of lunate articular surface of the acetabulum in the present study
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 | Figure 4: Shape of ends of lunate articular surface. 1 – Anterior end angulated; posterior end lunate 2 – Both ends lunate
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On morphometry of the acetabulum, the mean VD was 48.21 mm ± 3.31, TD was 47.81 mm ± 3.37 mm, APD was 48.79 mm ± 4.08 mm, ND was 23.58 mm ± 2.77 mm, depth was 27.45 mm ± 3.02 mm, SA was 4162.56 mm2 ± 755.58, and V was 36,563.65 mm3 ± 9408.67 [Table 2]. | Table 2: Morphometric values of the acetabulum of the right side, left side, and total
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On paired t-test, there was no significant difference found between the right and left side values [Table 3]. Statistical analysis using Pearson's correlation test proved an existing correlation between depth versus SA, depth versus V, and SA versus V [Table 4]. | Table 3: Comparison of morphometric values of the right and left sides of the acetabulum
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 | Table 4: Correlation between depth, surface area, and volume of the acetabulum of the hip bone
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| Discussion | | |
Knowledge of morphology of the anterior acetabular ridge is very important for total hip arthroplasty. Posterior acetabular ridge almost always forms a simple semicircle. However, the anterior acetabular ridge shows variations, and because of these variations, the amount of anteversion is affected by the point of measurement along the anterior ridge.[3] In the present study, the most common shape of the anterior margin of the acetabulum was curved, followed by angular, straight, and irregular; similar finding was reported by Thoudam and Chandra,[8] whereas Maruyama et al.[3] and Govsa et al.[5] reported most common shape as curved, followed by angular, irregular than straight [Table 5]. | Table 5: Different shapes of the anterior acetabular margin reported by different studies
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Anterior and posterior ends of the articular surface were angulated and lunate. In the present study, all posterior end was lunate in shape which differed from other findings [Table 6]. | Table 6: Comparison of shape of the anterior and posterior ends of the lunate surface of the acetabulum
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The mean diameter of the acetabulum of the present study was 48.27 mm ± 3.34 mm, which was similar with the findings reported by Yugesh and Kumar[14] and Gangavarapu and Muralidhar,[9] whereas Aksu et al.[12] and Thoudam and Chandra[8] reported higher values and Gaurang et al.[13] reported less value of the mean diameter of the acetabulum [Table 7]. | Table 7: Mean diameter and depth of the acetabulum reported by various studies
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The mean VD, TD, and AP diameter of the acetabulum were measured as 48.21 mm ± 3.31 mm, 47.81 mm ± 3.37 mm, and 48.79 mm ± 4.08 mm, respectively, in the present study, which was almost similar with the findings of the Jadhav et al.[15] [Table 8]. | Table 8: Various diameters and surface area of the acetabulum measured by different studies
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DH measured by Yugesh and Kumar[14] and Salamon et al.[16] was higher than that of the present study. In the present study, DH was 27.45 mm ± 3.02 mm, which was higher than the findings of Gaurang et al.[13] and Saikia et al.,[17] whereas findings of Thoudam and Chandra[8] and Khobragade and Vatsalaswamy[18] have similar values of DH as the present study [Table 7].
SA in the present study was calculated by mathematical formulas whereas other studies used different methods to calculate the SAs. Jadhav et al.[15] recorded the SA in female as 1900 mm2, in male as 2300 mm2, and Salamon et al.[16] reported 2294 mm2 ±329.5. In the present study, SA was 4162.56 mm2 ±755.58, which was higher; it may be because of different methods used for measuring the SAs [Table 8].
In the present study, V of the acetabulum was calculated by mathematical formulas, and it was 36,563.65 mm3 (36.56 ml). Other studies used different other methods to measure the V of the acetabulum. Tan et al.[19] measured V which was almost same as the present study (31.5 cm3), whereas other authors such as Kordelle,[20] Chung et al.,[21] Khobragade and Vatsalaswamy,[18] and Vivekbabu et al.[22] reported less value than the present study [Table 9].
The width of acetabular notch (inter ND) in the present study was measured as 23.58 mm ± 2.77 mm. The finding was similar to the findings of Gangavarapu and Muralidhar.[9] Yugesh and Kumar[14] reported higher values than that of the present study [Table 10]. | Table 10: Internotch distance of the acetabulum measured by various authors
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| Conclusion | | |
Clinically, the knowledge of morphology of the anterior acetabular ridge and various dimensions of the acetabulum is very important to orthopedician for hip surgeries and to construct suitable prostheses. The data of the present study may also help the forensic science faculty, orthopedicians, and prosthetists.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Last RJ. Lower limb. In: McMinn RM, editor. Last's Anatomy Regional and Applied. 9 th ed. New York: Churchill Livingstone; 1996. p. 215-6.  |
| 2. | Standring S. Pelvic girdle, gluteal region and hip joint. In: Williams A, editor. Grays Anatomy: The Anatomical Basis of Clinical Practice. 39 ed. New York: Elsevier Churchill Livingstone; 2005. p. 1421, 1440. |
| 3. | Maruyama M, Feinberg JR, Capello WN, D'Antonio JA. The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: Anteversion angle and implant positioning. Clin Orthop Relat Res 2001;1:52-65. |
| 4. | Varodompun N, Thinley T, Visutipol B, Ketmalasiri B, Pattarabunjerd N. Correlation between the acetabular diameter and thickness in Thais. J Orthop Surg (Hong Kong) 2002;10:41-4. |
| 5. | Govsa F, Ozer MA, Ozgur Z. Morphologic features of the acetabulum. Arch Orthop Trauma Surg 2005;125:453-61. |
| 6. | Kulkarni GS. Surgical anatomy of hip joint. Total Hip Arthroplasty. Textbook of Orthopedics and Trauma. 1 st ed. New Delhi: Jaypee Brothers Medical Publishers Pvt. Ltd.; 1999. p. 2910, 3685. |
| 7. | Sadler TW. Langman's Medical Embryology. 7 th ed. Maryland: Lippincott Williams and Wilkins; 1995. p. 154-60. |
| 8. | Thoudam BD, Chandra PX. Actabulaum-morphological and morphometrical study. Res J Pharma Biol Chem Sci 2014;5:793-9. |
| 9. | Gangavarapu S, Muralidhar RS. The study of morphology and morphometry of acetabulum on dry bones. Int J Anat Res 2017;5:4558-62. |
| 10. | Davivongs V. The pelvic girdle of the Australian aborigine; sex differences and sex determination. Am J Phys Anthropol 1963;21:443-55. |
| 11. | Andrei D, Alexander V. Handbook of Mathematics for Engineers and Scientists. 1 st ed. Florida: CRC Press; 2006. p. 1544. |
| 12. | Aksu FT, Ceri NG, Arman C, Tetik S. Morphology and morphometry of the acetab-ulum. DEÜ Tip Fakültesi Derg 2006;20:143-8. |
| 13. | Gaurang P, Reliab SR, Patel SV, Patel SM, Jethvaa N. Morphology and morphometry of acetabulum. Indian J Biol Med Res 2013;4:2924-6. |
| 14. | Yugesh K, Kumar SS. Morphometric analysis of acetabulum and its clinical correlation in South Indian population. IJAR 2016;2:1011-4. |
| 15. | Jadhav S, Rokade S, Nomulwar S, Ahire P, Bahetee B. Morphometric study of acetabulum. Appl Physiol Anat Dig 2017;2:26-34. |
| 16. | Salamon A, Salamon T, Sef D, Jo-Osvatic A. Morphological characteristics of the acetabulum. Coll Antropol 2004;28 Suppl 2:221-6. |
| 17. | Saikia KC, Bhuyan SK, Rongphar R. Anthropometric study of the hip joint in Northeastern region population with computed tomography scan. Indian J Orthop 2008;42:260-6. [ PUBMED] [Full text] |
| 18. | Khobragade L, Vatsalaswamy P. Morphometric study of depth of acetabulum. Int J Res Med Sci 2017;5:3837-42. |
| 19. | Tan V, Seldes RM, Katz MA, Freedhand AM, Klimkiewicz JJ, Fitzgerald RH Jr., et al. Contribution of acetabularlabrum to articulating surface area and femoral head coverage in adult hip joints: An anatomic study in cadavera. Am J Orthop (Belle Mead NJ) 2001;30:809-12. |
| 20. | Kordelle J, Richolt JA, Millis M, Jolesz FA, Kikinis R. Development of the acetabulum in patients with slipped capital femoral epiphysis: A three-dimensional analysis based on computed tomography. J Pediatr Orthop 2001;21:174-8. |
| 21. | Chung CY, Choi IH, Cho TJ, Yoo WJ, Lee SH, Park MS, et al. Morphometric changes in the acetabulum after dega osteotomy in patients with cerebral palsy. J Bone Joint Surg Br 2008;90:88-91. |
| 22. | Vivekbabu B, Yuvarajbabu K, Ganeshmohanraj K. Morphological and morphometrical analysis of acetabulum with special reference to volume in dry human pelvic bone. Drug Invention Today 2018;10:1921-3. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10]
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