FP6.5 Disorders of Functional Acetabular Overcoverage: A Scoping Review and Proposed Morphological Mechanistic Framework

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ID: 331126
2026
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Abstract
Abstract ICLA06 - Finetuning FAI Surgery: Advanced Corrections and Avoiding Yatrogenic Instability, Auditorium A (BMCC Level 1), October 8, 2026, 14:00 - 16:00 Introduction Disorders of acetabular overcoverage are morphologically heterogenous, with plain radiographs and terms such as pincer, femoroacetabular impingement, and acetabular retroversion failing to consider three-dimensional morphology and overall containment. Consequently, acetabular overcoverage pathologies remain inconsistently defined and investigated, creating variability in treatment strategy. This scoping review aims to explore these discrepancies in the literature and propose a morphological mechanistic framework to guide the definition, investigation, and management of functional acetabular overcoverage disorders. Methods We conducted a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using Medline and EMBASE databases from 1st January 1964 to 1st April 2026, to identify primary research design or high-quality review studies. There were 456 unique citations included after the removal of duplicates and initial screening. Full text review and data extraction is currently underway. Results Preliminary findings demonstrate substantial heterogeneity in terminology and radiological parameters used to define and investigate acetabular overcoverage pathology. Critically, these terminologies are often used to solely define the focal area of aberrant femoroacetabular contact, rather than describe three-dimensional acetabular morphology. A comprehensive understanding of three-dimensional acetabular morphology is crucial to guide appropriate surgical decision making, as overlooking global containment may inadvertently compromise hip stability. Furthermore, there is no clearly consistent framework for the integration of pelvis tilt and femoral version, both of which have been demonstrated to influence femoroacetabular contact. Based on early data extraction, we propose a diagnostic framework that would re-define acetabular overcoverage pathologies to describe overall three-dimensional acetabular morphology whilst integrating concurrent spinopelvic alignment and femoral version, under the following terminology: maldistributive overcoverage, focal overcoverage, global overcoverage, mixed overcoverage, and apparent overcoverage. Conclusion Based on the current heterogeneity in the literature, we propose an acetabular overcoverage framework that focuses on three-dimensional morphology, encompassing coverage distribution and containment, to help reduce diagnostic inconsistency and align surgical treatment strategy with the underlying mechanistic pathology. We plan to validate this framework with a consensus study, hoping that clear morphological definitions will reduce literature and treatment heterogeneity, facilitating further research into optimising outcomes for acetabular overcoverage pathologies.
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Authors Victoria Knox, Matthew Wood, Mark Sohatee
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.045
URL
https://doi.org/10.1093/jhps/hnag043.045
Keywords Keywords not found

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