TP4.7 Identifying Three-Dimensional Acetabular Morphologic Characteristics Associated with the Presence of Radiographic Indicators of Acetabular Retroversion: A Statistical Shape Modeling Analysis

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ID: 331038
2026
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Abstract
Abstract Background Acetabular orientation, such as anteversion and retroversion, have been implicated in affecting hip arthroscopy outcomes for patients with femoroacetabular impingement syndrome (FAIS). Understanding varying degrees of acetabular version in three-dimensional space by correlating true morphology with two-dimensional radiographic signs will provide clinically generalizable information to guide surgical planning. Methods Patients treated by a single surgeon between February 2016 and October 2020 with an available MRI and enrollment in a prospective imaging registry were identified. The MRIs providing advanced imaging of the acetabulum were segmented. Radiographs of corresponding patients were then reviewed for Crossover Sign (COS), Ischial Spine Sign (ISS), and Posterior Wall Sign (PWS). Statistical shape modeling (SSM) was performed to detect global three-dimensional changes associated with COS, ISS, PWS, and combination retroversion signs (COS+ISS+PWS present on one radiograph). Results A total of 104 MRI scans from patients were segmented to generate three-dimensional acetabular models. Of these, 43 patients had a positive COS, 26 had a positive ISS, 46 had a positive PWS, and 16 demonstrated the presence of all three simultaneously. The model evaluating acetabuli positive for all three signs exhibited the most pronounced morphological changes following SSM, demonstrating a less prominent posterior wall and a deeper acetabular fossa (~1.1 mm). The anterior wall of these models also exhibited a more pronounced anterior acetabular rim ranging from 0.4 to 1.0 mm. Individually, the COS model contributed most to the combined model, as similar morphological trends were observed. The PWS model exhibited a recessed posterior acetabular rim (~1.0 mm), while the ISS model exhibited largely similar morphology to the control group. Conclusions Distinct three-dimensional morphological differences can be identified with the presence or absence of two-dimensional radiographic signs of acetabular retroversion. These findings represent an important step toward integrating three-dimensional acetabular morphology into surgical decision-making for hip preservation surgeries.
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Authors Ty Monty, Jack Yang, Joseph Brinkman, Jakob Ackermann, Steven P. Mell, Philip J. Malloy, Shane Nho, Catherine Yuh
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.160
URL
https://doi.org/10.1093/jhps/hnag043.160
Keywords Keywords not found

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