Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Am J Sports Med. 2024 Aug;52(10):2603-2610. doi: 10.1177/03635465241265679. Epub 2024 Aug 12.
The acetabular sourcil is commonly interpreted as a reliable radiographic representation of the weightbearing dome of the acetabulum, despite limited modern data. Assessment of weightbearing acetabular coverage has been described using both the sourcil edge and bone edge as anatomic landmarks, leading to confusion and potential misguidance in surgical decision-making and thus compromised patient outcomes.
PURPOSE/HYPOTHESIS: The purpose of this study was to characterize the 3-dimensional (3D) anatomic correlates of the sourcil-edge and bone-edge radiographic measurements on false-profile radiographs. It was hypothesized that the sourcil edge would represent anterolateral coverage and the bone edge would represent anterior coverage.
Descriptive laboratory study.
A total of 80 hips were grouped by large or small differences between bone-edge and sourcil-edge anterior center-edge angles, based on upper and lower quartiles of discrepancy. Three-dimensional surface mesh models and digitally reconstructed radiographs were generated from hip computed tomography scans. Sourcil-edge and bone-edge anterior center-edge angles were identified on digitally reconstructed radiographs and registered to the 3D models with fiducial markers. Intersections of bone-edge and sourcil-edge projection lines with the acetabular rim were obtained from the 3D models.
The bone-edge and sourcil-edge projections intersected the acetabular rim at clockface means of 2:05 ± 0:22 and 1:12 ± 0:25, respectively. The 3D models consistently demonstrated that, in both large- and small-discrepancy groups, the sourcil edge corresponded to the acetabular area just posterior to the anterior inferior iliac spine (AIIS) projection, and the bone edge corresponded to the weightbearing region inferior to the AIIS. Additionally, in large-discrepancy hips, the bone edge corresponded to more prominent acetabular coverage in the region inferomedial to the AIIS when compared with the small-discrepancy hips.
On false-profile radiographs, the sourcil edge corresponds to superior femoral head coverage, and the bone edge corresponds to anterosuperior coverage. Radiographs with a large discrepancy between sourcil-edge and bone-edge measurements demonstrate acetabular rim prominence in the region of the AIIS.
Characterizing the anatomic weightbearing regions of the acetabulum represented on false-profile radiographs facilitates improved clinical and intraoperative decision-making in hip preservation surgery, including acetabuloplasty and periacetabular osteotomy.
尽管现代数据有限，但髋臼骨嵴通常被解释为髋臼负重穹顶的可靠影像学表现。负重髋臼覆盖的评估既可以使用骨嵴边缘也可以使用骨边缘作为解剖学标志，这导致了手术决策中的混淆和潜在误导，从而影响了患者的结果。
目的/假设：本研究的目的是描述在假性侧位片上骨嵴边缘和骨边缘的放射测量的三维（3D）解剖学相关性。假设骨嵴边缘代表前外侧覆盖，骨边缘代表前侧覆盖。
描述性实验室研究。
根据骨嵴边缘和骨嵴边缘前缘中心边缘角之间的差异，将 80 个髋关节分为大或小差异组，基于四分位距的上限和下限。从髋关节 CT 扫描中生成 3D 表面网格模型和数字重建放射照片。在数字重建放射照片上识别骨嵴边缘和骨边缘前缘中心边缘角，并使用基准标记将其与 3D 模型匹配。从 3D 模型中获得骨边缘和骨嵴边缘投影线与髋臼边缘的交点。
骨边缘和骨嵴边缘的投影分别在时钟面平均值 2:05±0:22 和 1:12±0:25 处与髋臼边缘相交。3D 模型一致地显示，在大差异和小差异组中，骨嵴边缘对应于前下髂嵴（AIIS）投影后方的髋臼区域，而骨边缘对应于 AIIS 下方的负重区域。此外，在大差异髋关节中，与小差异髋关节相比，骨边缘对应于 AIIS 下内侧区域更明显的髋臼覆盖。
在假性侧位片上，骨嵴边缘对应于股骨头的上覆盖，骨边缘对应于前上覆盖。在骨嵴边缘和骨边缘测量之间存在较大差异的放射片中，髋臼边缘在 AIIS 区域突出。
描述假性侧位片上代表髋臼的解剖学负重区域有助于改善髋关节保留手术中的临床和术中决策，包括髋臼成形术和髋臼周围截骨术。
