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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Coxa profunda: is the deep acetabulum overcovered?

Lucas A Anderson¹, Ashley L Kapron, Stephen K Aoki

¹Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Clinical Orthopaedics and Related Research

|August 18, 2012

Summary

Coxa profunda, a deep acetabular socket, is a common finding but does not indicate acetabular overcoverage. This study suggests abandoning its use for diagnosing pincer femoroacetabular impingement (FAI).

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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

Published on: July 2, 2021

Area of Science:

Orthopedic surgery
Radiology
Hip biomechanics

Background:

Coxa profunda, characterized by a deep acetabular socket, is radiographically defined as the acetabular fossa lying medial to the ilioischial line.
This finding has been traditionally associated with the diagnosis of pincer femoroacetabular impingement (FAI).
However, the medial position of the acetabular fossa may not accurately reflect the degree of acetabular coverage.

Purpose of the Study:

To determine the incidence of coxa profunda across different patient cohorts.
To evaluate the association between coxa profunda and established radiographic parameters of acetabular coverage.
To assess the utility of coxa profunda in diagnosing pincer FAI and acetabular dysplasia.

Main Methods:

Radiographic analysis of three distinct hip cohorts: 67 asymptomatic collegiate football players, 83 patients undergoing periacetabular osteotomy, and 96 patients undergoing surgical hip dislocation with osteochondroplasty.
Evaluation of coxa profunda, lateral center edge (LCE) angle, acetabular index, posterior wall sign, and crossover sign.
A level III diagnostic study was conducted.

Main Results:

No statistically significant difference in LCE angle or acetabular index was observed between hips with and without coxa profunda across all cohorts.
Coxa profunda was present in hips exhibiting a wide spectrum of acetabular coverage, as measured by the LCE angle (-18° to 60°).
The presence of coxa profunda did not correlate with an overcovered acetabulum.

Conclusions:

Coxa profunda is a frequent radiographic observation in both symptomatic and asymptomatic individuals.
The study concludes that coxa profunda is not indicative of acetabular overcoverage.
The diagnostic utility of coxa profunda for pincer FAI should be reconsidered, favoring other indicators of focal or general acetabular overcoverage.