TP1.3 Data-driven decision support for borderline hip dysplasia using statistical shape modelling and Discrete Element Analysis

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ID: 331208
2026
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Abstract
Abstract Introduction The management of borderline hip dysplasia (BHD), defined by a lateral centre-edge angle of 18–25°, remains controversial, particularly when concomitant femoroacetabular impingement (FAI) is present. Differentiating instability-dominant from impingement-dominant morphology is challenging, creating uncertainty when selecting between arthroscopy and acetabular reorientation procedures. Current assessment relies largely on two-dimensional radiographic parameters, which do not fully capture the complex three-dimensional morphology of the hip. Statistical Shape Modelling (SSM) enables objective quantification of anatomical variation in three dimensions. This study aims to apply SSM to patients with BHD and FAI to identify significant morphological differences and determine whether specific shape features correlate with clinical presentation. Methods Eighty patients with BHD and concomitant FAI (LCEA 18–25°, acetabular index 10–15°, no prior hip surgery) will be recruited alongside 80 asymptomatic controls. Clinical data will include demographics, symptom profiles, physical examination findings, and radiographic measurements. High-resolution CT scans will be segmented to generate patient-specific three-dimensional hip models. SSM will be performed, with Principal Component Analysis used to identify dominant modes of shape variation. Multivariate analysis will compare morphology between groups, and correlation analysis will assess associations between shape variation and clinical findings. Results We anticipate that SSM will identify distinct three-dimensional morphological patterns in BHD with FAI compared to controls. Reduced posterior acetabular coverage and increased anteversion may correlate with posterior pain and features of instability, while reduced femoral head–neck offset may be associated with anterior groin pain typical of impingement. These findings may suggest that BHD represents a heterogeneous group with overlapping morphological features. Conclusion SSM provides an objective method for quantifying hip morphology in BHD with FAI. Linking anatomical variation to clinical presentation may improve diagnostic precision and support decision-making when selecting between arthroscopy and osteotomy. This may ultimately lead to more personalised treatment strategies and improved outcomes in hip preservation.
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Authors Kylin Hu, Vikas Khanduja
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.139
URL
https://doi.org/10.1093/jhps/hnag043.139
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