Araştırma143 Morphology ad Morphometry of the Acetabulum ACETABULUM UN MORFOLOJİSİ VE MORFOMETRİSİ Fuda TAŞTEKİN AKSU, Nazlı GÜLRİZ ÇERİ, Cada ARMAN, Süleyma TETİK Departmet of Aatomy, Dokuz Eylül Uiversity, Medical School Fuda TAŞTEKİN AKSU Dokuz Eylül Üiversitesi Tıp Fakültesi Aatomi Aabilim Dalı 35340 İciraltı, İZMIR Tel: (232) 4124361 e-posta: fuda.tasteki@deu.edu.tr 2006 DEÜ TIP FAKÜLTESİ DERGİSİ SUMMARY Acetabulum is a hemispherical cavity o the medial part of the hip joit. Aterior acetabular ridge s morphology is cliically importat durig total hip arthroplasty. Additioally the depth ad diameter of the acetabulum are importat durig surgical treatmet of acetabular fractures. Objective of this study is to determie the relatioship betwee the acetabular depth ad diameter. Additioally to describe the aterior acetabular ridge s morphology that ca be useful for diagosig cogeital acetabular dysplasia ad durig acetabular surgery. Material ad method: This study was coducted o 154 os coxae. Two morphometrical ad oe morphological parameters were evaluated. The distace betwee the acetabular ridge earest to body of ischium ad aterior iliac margi itersectig the acetabular ridge was amed as acetabular diameter. The distace betwee the deepest poit of acetabular cavity ad the horizotal plae touchig the acetabular edges was amed as acetabular depth. We evaluated the aterior acetabular ridge s shape morphologically ad classified them as follows (irregular, curved, straight ad agular). Correlatio betwee morphometrical parameters were ivestigated usig Pearso s test. p<0.05 was the sigificat level. Results: Regardig to aterior acetabular ridge shape morphology; the majority was curved 71 (46,1 ), 36 (23,3 ) were straight, 26 (16,8 ) were agular ad 21 (13,6 ) were irregular. The mea values for the acetabular depth ad diameter were 29.49 ± 4.2 mm ad 54.29 ± 3.8 mm respectively. Positive ad sigificat correlatio was foud betwee the depth ad the diameter of the acetabulum (r = 0.498 p < 0.001). Coclusio: Depth of acetabulum correlates with acetabular diameter. Most commo acetabular shape is curved (46.1 ). These iformatio may be helpful durig hip arthroplasty, treatmet of hip joit fractures ad i diagosig cogeital hip dysplasia. Key words: Acetabulum, morphometry, morphology, aterior acetabular ridge ÖZET Acetabulum kalça eklemii medial bölümüde yer ala hemisferik şekilli bir çukurdur. Acetabulum ö kearı ı morfolojisi total kalça artroplastisi içi öemlidir. Acetabulum çapıı ve deriliğii bilimesi acetabulum kırıklarıı cerrahi tedavisi içi değerlidir. Amaç: Bu çalışmaı amacı acetabulum cerrahiside ve doğumsal acetabulum displazisi taısıda değer taşıya acetabulum deriliğii, çapıı, aralarıdaki ilişkiyi ve acetabulum ö kearıı morfolojisii taımlamaktır. Gereç ve yötem: Bu çalışma 154 kalça kemiğide yapıldı. İki morfometrik ve bir morfolojik parametre değerledirildi. Corpus ischii ye e yakı acetabulum kearı ve iliak kemik ö kearıı acetabulum kearıı kestiği okta arasıdaki uzaklık acetabulum çapı olarak adladırıldı. Acetabulum daki e deri okta ile acetabulum kearlarıa teğet geçe yatay pla arasıdaki dikey uzaklık acetabulum deriliği olarak adladırıldı. Acetabulum CİLT 20, SAYI 3, (EYLÜL) 2006, S: 143-148
144 Morphology ad morphometry of the acetabulum ö kearı morfolojik olarak değerledirildi ve dört farklı grup halide (kavisli, açılı, düz ve irregü- ler) sııfladırıldı. Bulgular: Acetabulum ö kearı 154 kemiği 71 ide kavisli (46,1), 36 sıda düz ( 23,3), 26 sıda köşeli (16,8), 21 ide irregüler (13,6) olarak buludu. Morfometrik ölçümler ola acetabulum deriliği ve çapı ortalama 29,49 ± 4,2 mm ve 54,29 ± 3,8 mm olarak buludu ve iki parametre arasıdaki korelasyo Pearso testi ile sıadı. Acetabulum deriliği ve çapı arasıda pozitif ve alamlı korelasyo saptadı (r = 0,498, p < 0,001). Souç: Acetabulum deriliği, acetabulum çapı ile ilişkilidir. E fazla görüle acetabulum kearı şekli kavisli dir (46,1). Bu bilgi kalça artroplastisi sırasıda, kalça eklemi kırıklarıı tedaviside ve kojeital kalça eklemi displazisi taısıda yararlı olabilir. Key words: Acetabulum, morfometri, morfoloji, acetabulum ö kearı Acetabulum is a hemispherical cavity o the medial betwee the acetabular ridge earest to corpus ischii ad part of the hip joit (1). Aterior acetabular ridge aterior iliac margi itersectig the acetabular ridge was morphology is importat i total hip arthroplasty. It is amed as acetabular diameter (Figure 1). The vertical valuable to kow the diameter (AD1) ad depth (AD2) of distace betwee the deepest poit of acetabular cavity the acetabulum for surgical treatmet of acetabular ad the horizotal plae touchig the acetabular edges fractures. aterior was amed as acetabular depth (Figure 2). We evaluated acetabular ridge s morphology regardig whether there is the aterior acetabular ridge s shape morphologically ad proportio betwee the diameter ad thickess of the classified them as follows (irregular, curved, straight ad acetabulum (2,3). Murphy studied o prehistorical New agular). Previous studies evaluated Zealad Polyesia hip boes the ad evaluated the usefuless of acetabulum diameter i determiig the geder (4). Patriqui et al. studied correlatios betwee AD2 ad os coxae measures to determie the geder (5). Ha et. al tried to determie the utility of several acetabular parameters i acetabular dysplasia diagosis (6). Aktaş et al. described the acetabular dysplasia frequecy ad ormal hip joit morphometry i adult Turks (7). Govsa et al. described the aterior acetabular ridge s shape morphologically (8). Başaloğlu et al. measured the vertical ad trasvers diameters of acetabulum i both sexes comparatively (9). I this study we aimed to determie the relatioship betwee acetabular depth ad diameter. Additioally to describe the aterior acetabular ridge s morphology that ca be useful for diagosig cogeital acetabular dysplasia diagosis ad durig acetabular surgery. MATERIAL AND METHODS This study was held o 154 os coxae. Two morphometrical ad oe morphological parameters were evaluated. 0.1 mm. sesitive compass was used for morphometric measuremets. Correlatio betwee parameters were aalysed usig Pearso s correlatio test. p < 0.05 was the sigificat level. The distace
Araştırma145 Figure 1. The distace betwee the acetabular ridge earest to corpus ischii ad aterior iliac margi itersectig the acetabular ridge (acetabular diameter) (AD1) Figure 2. The vertical distace betwee the deepest poit of acetabular cavity ad the horizotal plae touchig the acetabular edges (acetabular depth )(AD2) sigificat correlatio was foud betwee the depth ad the diameter of the acetabulum (r = 0.498 p < 0.001). Figure 3. Straight type of aterior acetabular ridge DISCUSSION Cliically it is very importat to kow the morphology RESULTS Regardig aterior acetabular ridge shape morphology; the majority was curved 71 (46,1 ) (Figure 3), 36 (23,3 ) were straight (Figure 4), 26 (16,8 ) were agular (Figure 5), 21 (13,6 ) were irregular (Figure 6). of aterior acetabular ridge durig total hip arthroplasty. Maruyama et al. evaluated the morphology of aterior acetabular ridge to perform the hip joit implats correctly (2). The mea values for the acetabular depth ad diameter Our results differ from Maruyama et al. s (Table I). were 29.49 ± 4.2 mm ad 54.29 ± 3.8 mm respectively. Particularly, the high icidece of straight ridge i our The maximum ad miimum measuremets of acetabular study may be due to ethical origis. diameter were 65.5 mm, 44.8 mm ad acetabular depth were 38.6 mm, 22.6 mm respectively. Positive ad 2006 DEÜ TIP FAKÜLTESİ DERGİSİ Straight type of aterior acetabular ridge was see more tha Govsa at al. s (8)( Table II). CİLT 20, SAYI 3, (EYLÜL) 2006, S: 143-148
146 Morphology ad morphometry of the acetabulum i the preset because it was assessed i dry boe (29.49 ± 4.2 mm). Figure 4. Curved type of aterior acetabular ridge Figure 5. Agular type of aterior acetabular ridge Aktaş et al. performed a radiological study to determie the acetabular dysplasia ormal hip rate joit i morphometry Turkish adults. ad They measured the acetabular depth i various age groups ad foud depths betwee 10.00 ad 11.1 mm. I additio they reported that the morphometry of the hip joit displayed ethical differeces (7). The measuremets of AD1 i our study are similar with the measuremets of trasvers diameter of the acetabulum i Başaloğlu et al. s study (9). Varodompu et al. ivestigated if there is a statistically sigificat correlatio betwee acetabular diameter ad thickess ad could ot fid a statistically sigificat correlatio (3). Ha et al. coducted a radiological study ad Our study showed a sigificat correlatio betwee AD1 preseted the radiological parameters for acetabular ad AD2. This iformatio ca be beeficial for the early dysplasia diagosis. They measured the acetabular depth diagosis of acetabular dysplasia. radiologically ad foud that depth differ which decreases by agig (average AD2 10.9 ± 2.7 mm i wome ad 11.5 ± 2.6 mm i me) (6). AD1 measuremets were differet CONCLUSION Depth of acetabulum correlates with acetabular diameter. Most commo acetabular shape is curved (46.1
Araştırma147 ). These iformatio may be helpful durig hip arthroplasty, treatmet of hip joit fractures ad i diagosig cogeital hip dysplasia. Figure 6. Irregular type of aterior acetabular ridge Table I. The results of morphologic parameters reported i the preset study ad i the study of Maruyama et al. s. Shape of the outer ridge of aterior colum Curved Agular Irregular Straight Total Maruyama et al. 121 51 19 9 200 60,50 25,50 9,50 4,50 Preset study 71 26 21 36 154 46,10 16,88 13,63 23,37 Table II. The results of morphologic parameters reported i the preset study ad i the study of Govsa et al. s. Shape of the outer ridge of aterior colum Curved Agular 2006 DEÜ TIP FAKÜLTESİ DERGİSİ Govsa et al. 98 64 Preset study 43,36 28,33 71 26 46,10 16,88 CİLT 20, SAYI 3, (EYLÜL) 2006, S: 143-148
148 Morphology ad morphometry of the acetabulum Irregular Straight Total 37 27 226 REFERENCES 1. 5. Maruyama M, Feiberg JR, Capello WN, D atoio JA. 2001;1:52-65. 3. 6. diameter ad thickess i Thais. J Orthop Surg (Hog Murphy AMC. The acetabulum: sex assessmet of prehistoric New Zealad Polyesia iomiates. Foresic Sciece Iteratioal 2000; 108: 39-41. Ha CD, Yoo JH, Lee WS, Choe WS. Radiographic Yosei Med J 1998; 39: 404-408. 7. Aktas S, Pekidil G, Erca S, Pekidil Y. Acetabular dysplasia i ormal Turkish adults. Bull Hosp Jt Dis 2000; 59: 158-162. 8. Govsa F, Ozer MA, Ozgur Z. Morphologic features of the acetabulum. Arch Orthop Trauma Surg 2005; 125: 453- Kog) 2002;10: 41-44. 4. Patriqui ML, Stey M, Loth SR. Metric assessmet of parameters of acetabulum for dysplasia i Korea adults. Varodompu N, Thiley T, Visutipol B, Ketmalasiri B, Pattarabujerd N. Correlatio betwee the acetabular 13,63 23,37 Iteratioal 2002;127: 104-113. Morphologic features of the acetabulum ad femur: ateversio agle ad implat positioig. Cli Orthop 21 36 154 race from the pelvis i South Africas. Foresic Sciece Stadrig S. Gray s Aatomy. Thirty-ith Editio. Elsevier Churchill Livigstoe 2005; 1421. 2. 16,37 11,94 461. 9. Başaloğlu H, Başaloğlu HK. Kadı ve erkek kalça kemiklerii acetabulumlarıı morfometrik icelemesi. 4. Ulusal aatomi Kogresi. İstabul.