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 (C
x,C
y,C
z) as a percentage of the corresponding pelvic dimensions (D
x,D
y,D
z). C
x/D
x averaged 9%, C
y/D
y 34%, and C
z/D
z 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.