EP4.3 A Computer Assisted Triangular Framework for Dimensional Digital Characterisation of Hip Morphology

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ID: 331329
2026
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Abstract
Abstract Background Conventional radiographic assessment of hip morphology relies on discrete angular and linear measurements, usually interpreted separately and referenced to normative geometric thresholds. In current practice, risk is commonly assigned by binary category, with hips labelled as normal or abnormal, stable or unstable, dysplastic or non-dysplastic. This links morphology to risk indirectly, through threshold-based classification, and does not allow direct titrated risk assessment across a continuous geometric spectrum. Conventional measures may also give conflicting information for the same hip, limiting consistent interpretation. Aim To develop and evaluate a geometric framework for dimensional representation of hip morphology, and to determine whether this framework can explain discordance between conventional radiographic metrics. Importantly the triangular framework incorporates, rather than replaces, established radiographic measures. Methods Pelvic radiographs from 39 subjects (78 hips) were analysed. Four anatomical landmarks were defined within a shared calibrated coordinate system: medial sourcil base, lateral sourcil apex, acetabular centroid, and femoral head centroid. From these landmarks, linked acetabular and interaction triangles were constructed, and geometric descriptors reflecting coverage, depth, congruence, orientation, and size were derived. Conventional radiographic measures were retained, mapped within the framework, and analysed using pairwise convergence testing, projection modelling, and principal component analysis to assess how they relate to the underlying geometric state. Results Conventional radiographic metrics frequently disagreed with one another when applied to the same hip. When acetabular depth ratio was included, 97.4% of hips had at least one measurement classed as within the reference range and at least one classed as outside it; after its removal, this remained high at 88.5%. Principal component analysis showed that the conventional measures largely collapsed into a single dominant pattern, with the first principal component explaining 71.3% of total variance. In contrast, the triangular descriptors preserved a broader multidimensional structure, with four independent components representing size, congruence, orientation, and coverage. Conclusion This novel morphological framework provides a structure that incorporates conventional radiographic metrics within a continuous, clinically interpretable geometric state space, providing the foundation for future outcome-linked risk titration and risk stratification in hip preservation.
Reference Key
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Authors Connor Green, Niamh Nowlan, Siobhan Hoare
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.337
URL
https://doi.org/10.1093/jhps/hnag043.337
Keywords Keywords not found

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