Hannah Sugirthabai RajilaRajendran ¹, R Abitha^2*, S Logithkumar² and Vaithianathan Gnanasundaram¹

¹Department of Anatomy, Chettinad Hospital and research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.

²Chettinad Hospital and research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.

Corresponding Author E-mail: abitharaja2022@gmail.com

DOI : https://dx.doi.org/10.13005/bpj/2846

Abstract

Aim- Acetabular dimensions plays a challenging role in various arthroplasties and reconstructions. Morphometric study of acetabulum of dry hip bones is a necessity to make proper prosthesis and to ensure good quality of life. Materials & methods - In this 71 dry human hip bones of 35 right and 36 left collected in department of anatomy of Chettinad Hospital and Research Institute, to analyze & measure the diameter, acetabular notch, acetabular circumference, depth and volume of acetabulum. Results – The transverse diameter on right- 49.33 ± 7.36 mm, left 48.57±6.79 mm, depth-right23.28±3.27 mm, left 22.50 ±3.18 mm, vertical diameter- right 48.05±4.40 mm, left 47.66±4.95 mm, acetabular notch- right 22.00±3.28 mm, left  20.56±2.61 mm, outer rim circumference -right 11.90±0.99 cm, left 12.43±0.87 cm, inner rim circumference- right 7.66±0.84 cm, left 8.06±0.72 cm, acetabular circumference- right 15.26±1.38 cm, left 14.60±1.35 cm, capacity- right 27.22±5.43 ml, left-27.22±5.77 ml. Conclusion - All the parameters were statistically analysed and the results suggest that the acetabular dimensions are mostly smaller in South Indian population and hip prosthesis should be made patient specific to increase the success rate of arthroplasties.

Keywords

Acetabulum; Arthroplasty; Biometry; Hip prosthesis

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Copy the following to cite this article: Rajila R. H. S, Abitha R, Logithkumar S, Gnanasundaram V. Profound Morphometric Analysis of Acetabulum in South Indian Population (Acetabular dimensions). Biomed Pharmacol J 2024;17(1).

Copy the following to cite this URL: Rajila R. H. S, Abitha R, Logithkumar S, Gnanasundaram V. Profound Morphometric Analysis of Acetabulum in South Indian Population (Acetabular dimensions). Biomed Pharmacol J 2024;17(1). Available from: https://bit.ly/3SQPqvB

Introduction

The Acetabulum is known as the vinegar cup. Its deep concavity faces laterally and anteroinferiorly .The cup shape socket forms the hip joint on articulation with the head of a femur which provides stability to the joint . Development of cavity embryologically begins at 4th to 6th week and completion of cavity happens at 8th week of intrauterine life. Triradiate cartilage (immature ischium, ilium and pubis) fuses to form acetabulum. The morphology of acetabulum shows 2 surfaces, a smo oth articulating lunate surface, which has its anterior and posterior end and a rough non articulating part called acetabular fossa covered with a pad of fat.^1,2,3 The peripheral moon-shaped articular surface of acetabulum covered by hyaline cartilage and deficient at the inferior margin forms acetabular notch. This gap is bridged by transverse acetabular ligament to form acetabular foramen. Knowledge of morphometry & anatomical framework is necessary to understand the mechanics and enhances the acumen to perform hip arthroplasties.^4,5 A joint incongruity may also lead to more dislocation & fractures. So a small change in any parameter of acetabulum leads to anatomical variations.

AIM

The morphometry of acetabular fossa enhances major baseline data for prosthesis construction of acetabulum .^6,7 In various hip dysplasia, damage to size and shape of acetabulum parameters are evaluated by applying measurements of acetabular parameters by an orthopedic surgeon. The present study aims to obtain morphometric data of various acetabular parameters which provide data to improve hip arthroplasty.

Materials and Methods

A total 71 hip bones of unknown sex were studied from Department of Anatomy of Chettinad Hospital and Research Institute. Out of 71 hip bones, 35 were of right side and 36 were of left side irrespective of age and sex, as these parameters can be included when the bones are derived from a single individual, which gives a precise idea. But, when the collection of bones are from different sources, the authenticity of the determination of sex and age becomes controversial. All the hip bones were fully ossified with intact normal anatomical features.

Specimens with any pathological evidences or damages were not included in the study. Measurements of the parameters were done with the help of digital vernier caliper, twine with measuring scale, plasticine, and urinometer. The parameters taken were vertical diameter, transverse diameter, acetabular notch width, acetabular rim, outer margin, inner margin, depth and capacity.

Vertical diameter: Maximum distance measured from the anterior superior iliac spine to prominent point on ischial tuberosity,

Transverse diameter: Maximum distance measured on acetabular rim in horizontal axis,

Depth: Distance measured from the brim of acetabulum to the deepest point in acetabular fossa with an thin metallic strip of vernier caliper.

Acetabular notch: Distance measured from the two end points of lunate with vernier caliper.

Acetabular Circumference: Circumference of the acetabular cavity measured over the lip of the

acetabulum.

Outer rim circumference: Circumference measured around the outer margin of anterior horn of

lunate surface to outer margin of posterior horn of lunate surface.

Inner rim circumference: Circumference measured around the inner margin of anterior horn of

lunate surface to inner margin of posterior horn of lunate surface excluding acetabular notch.

Capacity: A solid mass of plasticine was moulded to fill the entire acetabular cup till the circumference of acetabulum including acetabular notch. The excess plasticine after the filling was removed in order to provide proper morphometric evidence of volume of acetabulum.

Then the filled plasticine was taken and submerged in the measuring cylinder which was partially filled with water. So the volume of displaced fluid = volume of immersed object according to Archimedes principle. According to Force of buoyancy submerged volume=volume of object. All these values were analyzed statistically using SPSS software.

Results

The morphometry of acetabulum were measured and tabulated as below with side difference in respective units. Table 1 show the various results obtained during the study period. The value of acetabulum circumference in this study on right side was 15.26 ± 1.38 cm and left side was 14.60± 1.35 cm. Outer rim circumference on right side was 11.90±0.99 cm & left side was 12.43±0.87cm and inner rim circumference on right side was 7.66±0.84cm & left side wsa8.06±0.72cm.

Table 1: Results

ACETABULUM	SIDE	MEAN ± SD
TRANSVERSE DIAMETER	RIGHT	49.33 ± 7.36 mm
	LEFT	48.57±6.79 mm
DEPTH	RIGHT	23.28±3.27 mm
	LEFT	22.50 ±3.18 mm
VERTICAL DIAMETER	RIGHT	48.05±4.40 mm
	LEFT	47.66±4.95 mm
ACETABULAR NOTCH	RIGHT	22.00±3.28 mm
	LEFT	20.56±2.61 mm
OUTER RIM CIRCUMFERENCE	RIGHT	11.90±0.99 cm
	LEFT	12.43±0.87 cm
INNER RIM CIRCUMFERENCE	RIGHT	7.66±0.84 cm
	LEFT	8.06±0.72 cm
ACETABULAR CIRCUMFERENCE	RIGHT	15.26±1.38 cm
	LEFT	14.60±1.35 cm
CAPACITY	RIGHT	27.22±5.43 ml
	LEFT	27.22±5.77 ml

 

Discussion

Our study would give an elaborate idea of possible parameters in anthropometry of acetabulum of dry hip bone in South Indian population, which provides a strong anatomical knowledge to orthopedic surgeons for enhancing the success rate of hip arthroplasties. ^8,9,10,11 Anthropometry of acetabular fossa is a major baseline data for making hip prosthesis. ^12,13

Our study accounts for precise morphometric values of the possible parameters measurable in the acetabular cavity. The transverse diameters of acetabulum of right and left side were 49.33 ± 7.36 mm, and 48.57±6.79mm respectively. The transverse diameter reported by Gursharan, ¹⁴ was found to be greater than the same in the present study and quite nearer to value was reported by Archana ,¹⁵ 47.43±3.43mm and 48.13±3.33mm on right and left sides. The diameter of acetabular cavity on vertical axis was 48.05±4.40mm and 47.66±4.95mm on right and left side respectively. The same diameter as compared with Sridharan, was smaller and statistically significant with p value less than 0.05 on both sides (Table 2). ¹⁶

Table 2: Comparison Table

Parameters	Our Study	Gursharan 14	Archana 15	Ilankathir 16	Yugesh 17
TRANSVERSE DIAMETER[mm]	49.33 ± 7.36	51.3±2.6 P= 0.073	47.43±3.43 P=0.031
	48.57±6.79	50.3±3.5	48.13±3.33
		P= 0.103	P= 0.591
DEPTH[mm]	23.28±3.27	26.7±2.7 P<0.0001	26.73±3.06 P<0.0001	24.34 ±2.53 P=0.01499	29.9±0.21 P<0.0001
	22.50 ±3.18	26.4±3.0 P<0.0001	28.04±2.88 P<0.0001	24.35±2.54 P<0.0001	29.7±0.23 P<0.0001
VERTICAL DIAMETER[mm]	48.05±4.40		48.00±3.56 P= 0.938	50.43±3.88 P= 0.0002	47.4±0.27 P= 0.256
	47.66±4.95		48.38±3.12 P= 0.264	50.28±3.85 P<0.0001	48.0±0.37 P= 0.597
ACETABULAR NOTCH[mm]	22.00±3.28		23.11±2.70 P= 0.021	24.48±1.89 P<0.0001	30.8±0.42 P<0.0001
	20.56±2.61		23.98±2.79 P<0.0001	24.29±1.86 P<0.0001	31.1±0.72 P<0.0001
CAPACITY[ml]	27.22±5.43	36.68±6.23 P<0.0001
	27.22±5.77	33.56±5.63 P<0.0001

 

On the statistical analysis of the transverse and vertical diameters of acetabulum in our study, there was no significant difference between the parameters of the right and left side.

The depth of acetabulum in present study was 23.28±3.27mm on right side and 22.50 ±3.18mm on left side. Our values were smaller and statistically significant on comparison with the study of Sridharan.¹⁶ The comparison of the same with Archana of North Indian population is also statistically significant.¹⁵ The cavity depth in the South Indian population ranges from 23mm to 29mm with reference of other similar studies by Gursharan and Yugesh . ^14,17 The width of acetabular notch of present study was measured as 22.00±3.28mm and 20.56±2.61mm on right and left side. It was found that the findings were again smaller and statistically significant with Sridharan, Archana, and Yugesh as mentioned in [Table 2]. ^15,16,17

The morphometric knowledge of acetabular rim is very important for labral reconstruction, which is necessary to repair labral tears. In this study the value of acetabular rim measured was 15.26±1.38mm and 14.60±1.35mm on right and left side respectively. Outer rim of acetabulum on right and left side were 11.90±0.99mm and 12.43±0.87mm and the inner rim measured were 7.66±0.84mm and 8.06±0.72mm. This understanding of acetabular rim plays a main role in hip stability, but this parameter was infrequently noted in hip anthropometry studies, that have been done till date.

The volumes of acetabulum in this present study were 27.22±5.43mm and 27.22±5.77mm on right and left side respectively. The study by Gursharan, done by the same method showed a huge difference in volume with a comparatively greater range and significant statistically as well.¹⁴ Thereby the measured values enhanced by manual method are more accurate than the radiological method as these provide a better understanding for biomedical engineers for modeling the prosthesis as readings are near the real value. ^{18,19,20,21,22,23}

Conclusion

This study emphasizes mainly on the detailed knowledge of anatomical parameters of acetabulum which are more important & essential to orthopedic surgeons for various hip surgeries. The depth of acetabular cavity plays an important role in acetabular dysplasia. Acetabular rim parameters were studied in great detail and plays important role in labral reconstructions. The values obtained here are pertaining to a part of South Indian population . These values were very smaller when compared to other races and even other Indian states.

The study has proved the importance of making prosthesis at an individualized level, rather than on a general level. This knowledge of acetabular parameters is essential for anatomist, forensics experts and orthopaedicians to deliver their performances to the maximum in their specialties.

Acknowledgement

None

Conflict of Interest

There is no conflict of interest.

Funding Sources

None

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