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Quantifying Changes in 3D Acetabular Morphology in Normal Hips Based on the Development of Secondary Ossification
Rajvarun S Grewal1,2, Lukas G Keil1, James D Bomar1
1Rady Children's Hospital, San Diego, California.
The Journal of Bone and Joint Surgery. American Volume
|September 12, 2025
Summary
Adolescent hip development shows secondary ossification centers (SOCs) of the ilium and ischium influence acetabular coverage. Os pubis ossification does not impact anterior coverage, highlighting SOCs
Area of Science:
- Orthopedic research
- Pediatric skeletal development
- Hip biomechanics
Background:
- Acetabular development in pediatric hips is influenced by the triradiate cartilage (TRC) and secondary ossification centers (SOCs) of the os pubis, os ischium, and os ilium.
- These SOCs exhibit distinct timing of appearance and fusion, with sex-specific morphological variations.
- Understanding the role of SOCs is crucial for analyzing acetabular coverage, version, tilt, and surface area during adolescence.
Purpose of the Study:
- To quantify the impact of secondary ossification centers (SOCs) on acetabular coverage, version, tilt, and surface area during adolescence.
- To analyze the sex-specific differences in acetabular morphology during skeletal maturation.
Main Methods:
- Generated 3D surface reconstructions from CT scans of 540 normal hips (ages 8-19 years).
- Extracted acetabular parameters (coverage, version, tilt, surface area) using a validated algorithm.
- Assessed skeletal maturity with the Proximal Femur Maturity Index (PFMI) and analyzed SOC contributions using generalized linear mixed models.
Main Results:
- Os ilium ossification correlated with increased superior coverage (p < 0.001), and os ischium ossification with increased posterior coverage (p < 0.001).
- Superior coverage strongly correlated with lateral tilt (r s = 0.837), and posterior coverage with anteversion (r s = 0.788).
- Females showed greater acetabular anteversion and lateral tilt, while males had larger acetabular surface area. Os pubis ossification did not significantly impact anterior coverage.
Conclusions:
- Os ilium and os ischium ossification are key drivers of superior and posterior acetabular coverage during adolescence, respectively.
- Os pubis ossification does not appear to influence anterior acetabular coverage in this age group.
- The developmental timing of SOCs is closely linked to acetabular morphology changes, underscoring their role in hip stability.
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