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Abstract

Acetabular center positioning has an effect on hip function. However, reported clinical and plain radiographic methods are inaccurate and unreliable for ascertaining acetabular implant location. In an exploratory study we asked whether the normal acetabular position can be derived from simple radiographically measurable pelvic dimensions. We analyzed computed tomographic scans of 37 normal hips using a pelvic frame of reference centered on the ipsilateral anterior-superior iliac spine. We defined the x-, y-, and z-coordinates of the hip center (Cx,Cy,Cz) as a percentage of the corresponding pelvic dimensions (Dx,Dy,Dz). Cx/Dx averaged 9%, Cy/Dy 34%, and Cz/Dz 37%. These ratios had narrow distributions with small confidence intervals. Interobserver agreement tests showed a mean intraclass correlation coefficient of 0.95. We observed gender differences in the ratios of as much as 4%, which correspond to differences of as much as 9 mm in the hip center position. The ratios provide a simple and reliable way of deriving the normal position of the hip center from the pelvic dimensions alone. This gives the surgeon a simple way of planning where the hip center should be and may be particularly helpful in revision hip arthroplasty or in cases involving extensive osteophytes, dysplasia, or protrusio.
Each author certifies that he has no commercial associations (eg, 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 institution has approved or 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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