Quantitative assessment of acetabular bone defects: A study of 50 computed tomography data sets

Autoři: Ronja A. Schierjott aff001;  Georg Hettich aff001;  Heiko Graichen aff003;  Volkmar Jansson aff002;  Maximilian Rudert aff004;  Francesco Traina aff005;  Patrick Weber aff002;  Thomas M. Grupp aff001
Působiště autorů: Research & Development Department, B.Braun Aesculap AG, Tuttlingen, Germany aff001;  Department of Orthopaedic Surgery, Physical Medicine & Rehabilitation, Ludwig-Maximilians-University Munich, Campus Grosshadern, Munich, Germany aff002;  Department for Arthroplasty and General Orthopaedic Surgery, Orthopaedic Hospital Lindenlohe, Schwandorf, Germany aff003;  Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, Würzburg, Germany aff004;  Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d'Anca e di Ginocchio, Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy aff005;  Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Università Degli Studi Di Messina, Messina, Italy aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222511



Acetabular bone defect quantification and classification is still challenging. The objectives of this study were to suggest and define parameters for the quantification of acetabular bone defects, to analyze 50 bone defects and to present the results and correlations between the defined parameters.


The analysis was based on CT-data of pelvises with acetabular bone defects and their reconstruction via a statistical shape model. Based on this data, bone volume loss and new bone formation were analyzed in four sectors (cranial roof, anterior column, posterior column, and medial wall). In addition, ovality of the acetabulum, lateral center-edge angle, implant migration, and presence of wall defects were analyzed and correlations between the different parameters were assessed.


Bone volume loss was found in all sectors and was multidirectional in most cases. Highest relative bone volume loss was found in the medial wall with median and [25, 75]—percentile values of 72.8 [50.6, 95.0] %. Ovality, given as the length to width ratio of the acetabulum, was 1.3 [1.1, 1.4] with a maximum of 2.0, which indicated an oval shape of the defect acetabulum. Lateral center-edge angle was 30.4° [21.5°, 40.4°], which indicated a wide range of roof coverage in the defect acetabulum. Total implant migration was 25.3 [14.8, 32.7] mm, whereby cranial was the most common direction. 49/50 cases showed a wall defect in at least one sector. It was observed that implant migration in cranial direction was associated with relative bone volume loss in cranial roof (R = 0.74) and ovality (R = 0.67).


Within this study, 50 pelvises with acetabular bone defects were successfully analyzed using six parameters. This could provide the basis for a novel classification concept which would represent a quantitative, objective, unambiguous, and reproducible classification approach for acetabular bone defects.

Klíčová slova:

Biomaterial implants – Bone development – Cements – Computed axial tomography – Hip – Medical implants – Pelvis – Surgeons


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2019 Číslo 10
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