Acetabular rim length: an anatomical study to determine reasonable graft sizes for labral reconstruction

Abstract

The purpose of this article is to determine normative values for the length of the acetabular rim and detect differences between gender, age, ethnicity, height and leg length. Six measurements were taken on the acetabular rim of 143 cadaveric skeleton specimens (286 acetabula) using a coordinate-measuring device: circumferential (excluding acetabular notch), anterior inferior iliac spine (AIIS)-anterior, AIIS-posterior, 12–3 o’clock, 12–9 o’clock and 11–5 o’clock. Museum specimen height data and leg length data from a previous study were recorded for 109 of 143 specimens. Intraclass correlation coefficients were calculated. Student t-tests compared mean values. Multiple regression analysis was used to determine the relationship between acetabular rim length and gender, age, ethnicity, height and leg length. The average acetabular rim length in males for circumferential, AIIS-anterior, AIIS-posterior, 12–3, 12–9 and 11–5 o’clock were 15.8, 4.2, 11.7, 4.9, 4.7 and 9.5 cm, respectively; and for females: 13.7, 3.7, 10.0, 4.3, 4.1 and 8.3 cm, respectively. Intraclass correlation coefficients were 0.953, 0.930, 0.958, 0.857, 0.913 and 0.951, respectively, for each measurement. All six measurements were significantly larger for males (P < 0.001). Multiple regression analysis demonstrated a significant relationship between gender and rim length for all six measurements (P < 0.001) and between height and leg length and acetabular rim length for five of the six measurements exclusive of AIIS-anterior (P < 0.001). No significant trends between age or ethnicity and rim length were found. Average acetabular rim lengths were established. The acetabular rim is significantly longer in males and correlates with height and leg length. Age and ethnicity do not appear to be significant predictors of acetabular rim length. Normative values for acetabular rim lengths may assist in hip preservation surgery.

Tall-Statured Patients Have Similar Outcomes to Normal Height Patients after Primary Total Hip Arthroplasty

“…58 mm versus 24% of the normal cohort having similar cup size (p < 0.001). Our findings, although intuitive, are also in line with the Karns et al 22 cadaveric study that demonstrated acetabular diameter to be correlated with a patient's height and leg length. Interestingly, their results also found acetabular rims to be significantly longer in males and did not find age or ethnicity to be significant predictors.…”

Reconstruction Guide for the Measurement of Segmental Labral Insufficiency: An Alternative Technique for Acetabular Labral Reconstruction

“…Conventional labral reconstruction techniques involve using a burr or an object of known length to incrementally measure the defect size and to determine the graft length. 11 This technique can be prone to substantial measurement error from estimation and assumption of standardized length of common surgical devices. Perets et al.…”

“… 7 , 8 , 9 , 10 A critical component of labral reconstruction is accurately matching the graft length to the patient's native anatomy. 11 Mismatch between graft length and acetabular rim size can cause the graft to be overconstrained or too loose, making fixation more challenging and possibly compromising the suction seal between the graft and the femoral head. 11 The purpose of this Technical Note is to describe a method to measure intra-articular graft length during labral reconstruction.…”

Sex Differences in Morphometry of North Indian Acetabula—Forensic and Orthopedic Consideration

“…Also, it was more on right side in both males and females, but insignificantly (p-value = 0.381 in males and 0.704 in females). Karns et al 28 in their study on acetabular rim length, to calculate graft sizes for reconstruction of acetabular labrum, also stated that no study has looked specifically at overall acetabular rim lengths or rim arc lengths which are must for graft during total and subtotal labral reconstructions. If known, this would add to our overall understanding of periacetabular morphology and may assist with operative planning during arthroscopic hip preservation surgery.…”

“…If known, this would add to our overall understanding of periacetabular morphology and may assist with operative planning during arthroscopic hip preservation surgery. 28 They conducted the study on 143 sets of acetabula of which 90 (63%) were male, and 53 (37%) were female, the values being 1.582 cm and 1.367 cm, respectively. Thus toeing in line with the present study, values were significantly more in males.…”