Related Experiment Video
Updated: Oct 12, 2025
Author Spotlight: A Novel 3D-Printed Titanium Implant for Minimally Invasive Treatment of Hip Dysplasia in Young Dogs
Published on: April 19, 2024
Bone defect map of the true acetabulum in hip dysplasia (Crowe type II and III) based on three-dimensional image
Xinggui Wen1, Jianlin Zuo2, Tong Liu2
1Department of Hand Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Avenue, Changchun, 130033, Jilin, China.
Insights
The high hip center technique effectively reconstructs acetabula in Crowe type II and III hip dysplasia, achieving over 70% cup coverage. This method, particularly with a 44mm cup, offers satisfactory results for most patients without further surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Developmental Dysplasia of the Hip (DDH) often requires acetabular reconstruction.
- The high hip center (HHC) technique is a potential solution, but its efficacy in specific DDH types (Crowe II-III) needs detailed investigation.
Purpose of the Study:
- To evaluate the impact of the HHC technique on acetabular cup coverage (CC) in Crowe type II and III DDH.
- To create a bone defect map for acetabular reconstruction in these patient groups.
Main Methods:
- Simulated acetabular reconstruction using CT data from 39 patients with Crowe type II/III DDH.
- Analysis of cup coverage with varying cup sizes (38-50mm) using the HHC technique.
- Frequency distribution mapping of bone defects relative to cup placement.
Main Results:
- Mean cup coverage at the true acetabulum ranged from 71.75% (50mm cup) to 77.85% (38mm cup).
- Elevation via HHC increased cup coverage significantly (up to 21.58%).
- A bone defect map revealed posterosuperior defects in 95% of cases, with 60% outside the hip's force line.
- A 44mm cup achieved >70% CC in the true acetabulum for ~60% of patients.
Conclusions:
- The HHC technique is feasible for acetabular reconstruction in Crowe type II/III DDH.
- A 44mm acetabular cup provides satisfactory coverage for a majority of these patients without additional procedures.
- Understanding the pattern of bone defects aids surgical planning.
Abstract:
The high hip center technique (HHC) is considered to be feasible for acetabular reconstruction in patients with DDH, but there is little in-depth study of its specific impact on Crowe type II and III DDH. The purpose of this study was to simultaneously analyze the effect of HHC on bone coverage of the cup (CC) in the acetabular reconstruction of type II and III DDH patients and to propose a map of acetabular bone defects from the perspective of the cup. Forty-nine hip CT data of 39 patients with DDH (Crowe type II and III) were collected to simulate acetabular reconstruction by cup models of different sizes (diameter 38mm-50 mm, 2 mm increment) with the HHC technique. The frequency distribution was plotted by overlapping the portions of the 44 mm cups that were not covered by the host bone. The mean CC of cups with sizes of 38 mm, 40 mm, 42 mm, 44 mm, 46 mm, 48 mm, and 50 mm at the true acetabula were 77.85%, 76.71%, 75.73%, 74.56%, 73.68%, 72.51%, and 71.75%, respectively, and the maximum CC increments were 21.24%, 21.58%, 20.86%, 20.04%, 18.62%, 17.18%, and 15.42% (P < 0.001), respectively, after the cups were elevated from the true acetabula. The bone defect map shows that 95% of type II and III DDH acetabula had posterosuperior bone defects, and approximately 60% were located outside the force line of the hip joint. Acetabular cups can meet a CC of more than 70% at the true acetabulum, and approximately 60% of Crowe type II and III DDH patients can obtain satisfactory CC at the true acetabulum by using a 44-mm cup without additional operations.
