Int J Anat Res 2014, 2(3):549-52. ISSN 2321-4287 549 Original Article
A STUDY ON M ORPHOM ETRIC M EASUREM ENT OF VOLUM E OF
ACETABULUM
Leena Khobragade *
1, P. Vatsalaswamy
2.
ABSTRACT
Address for Correspondence: Dr. Leena Khobragade, Assistant Professor, Depart ment of Anat omy, Shri Vasant rao Naik Government M edical College, Yavat mal, M aharasht ra, India.
M obile No. +919766126303. E-M ail: [email protected]
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* 1 Assistant Professor, Depart ment of Anat omy, Shri Vasant rao Naik Government M edical College,
Yavat mal, M aharasht ra, India.
2 Professor, Depart ment of Anat omy, Padmashree Dr. D. Y. Pat il M edical college, Hospital and
Research cent re, Pimpri, Pune, M aharasht ra, India.
Background: Hip joint represent s an unique funct ional unit and has com plex biom echanical const ruct ion. In t oday’s era w here t otal hip replacem ent surgeries have m ade t heir w ay it has becom e im perat ive for t he anat om ist s t o know t he variat ions in acet abular dim ensions. Reconst ruct ion of acetabulum in pat ient s w it h significant acetabular bone deficiency rem ains a challenge. Hence t he present st udy w as carried out w it h t he aim t o st udy t he m orphom et r ic m easurem ent of volum e of acetabulum in bot h t he sexes.
M aterials and M ethods: M at erial of t he st udy consist ed of 110 hum an hip bones (60 m ales and 50 fem ales). Volum e of Acetabulum (VA) w as m easured on t hese hip bones on bot h t he sides. St at ist ical analysis w as done using SPSS (Stat ist ical Package for t he Social Sciences) version 11 and M icrosoft Excel 2007.
Results:The m ean volum e of acetabulum in m ale w as 23.13 m l and fem ale w as 17.88 m l. The m ean volum e of acetabulum on right side w as 20.55 m l and lef t side w as 20.91 m l.Volum e of t he acetabulum w as great er in m ales as com pared t o fem ales and t he differences w ere stat ist ically significant .Volum e w as great er on t he left side as com pared t o t he right side but t he dif ference w as stat ist ically non significant .
Discussion:Analysing t he differences on hum an acetabulum is helpful in understanding not only m orphological but also m edicolegal aspect s.
Conclusion: Volum e of t he acetabulum w as great er in m ales as com pared t o fem ales.
KEY W ORDS:Acetabulum ; Volum e; Hip replacem ent ; Reconst ruct ion.
INTRODUCTION
Int ernat ional Journal of Anatomy and Research, Int J Anat Res 2014, Vol 2(3):549-52. ISSN 2321- 4287
Received: 03 Aug 2014
Peer Review : 03 Aug 2014 Published (O):19 Sep 2014 Accepted: 27 Aug 2014 Published (P):30 Sep 2014
Internat ional Journal of Anat omy and Research ISSN 2321-4287
w w w.ijmhr.org/ ijar.ht m
The acetabulum (L. shallow vinegar cup) is t he large cup shaped cavit y or socket on t he lateral aspect of t he hip bone t hat art iculates w it h t he head of t he femur t o form t he hip joint . The acetabular fossa forms t he cent ral floor and is rough and non art icular. The art icular lunat e surface is w idest above (t he ‘dom e’), w here w eight is t ransm it ted t o t he fem ur. Fract ures t hrough t his region t herefore often lead t o poor
Int J Anat Res 2014, 2(3):549-52. ISSN 2321-4287 550
Leena Khobragade, P. Vat salasw amy. A STUDY ON M ORPHOM ETRIC M EASUREM ENT OF VOLUM E OF ACETABULUM .
surface is broadest . The acetabular fossa w it hin it is devoid of cart ilage but contains fibroelast ic fat largely covered by synovial m em brane. Acetabular dept h is increased by t he acetabular labrum, a fibrocart ilaginous rim attached t o t he acetabular margin. This deepens t he cup and bridges t he acetabular notch as t he t ransverse acet abu lar li gam en t. The d iam et er of t he acetabular cavit y is const ricted by t he labral rim, w hich embraces t he femoral head, maintaining joint stabilit y bot h as a stat ic rest raint and by providing propriocept ive informat ion as stated by Standring [1]. M oore [2] describes t hat t he m alleable nat ure of t he fat-pad perm it s it t o change shape t o accommodate t he variat ions in t he congruit y of t he femoral head and acetabu-lum as w ell as changes in t he posit ion of t he ligament of t he head during joint movement s. The acetabulum is divided int o t hree zones t o find out t he degree of loosening of acetabulum. Zone I -Superior one-t hird, Zone II -M iddle one-t hird and Zone III-Posteroinferior one-t hird according t o Kulkarni [3]. Since t he acetabulum is not alw ays of same shape, w idt h or dept h, j oint congruences are f requent w it h m inor an at o m ical var iat ions in t h e shap e o f t he acet abulum . Hence t he present st udy w as undert aken as cont roversies st ill exist on t he importance of t hese variat ions and t o prevent problems follow ing surgical procedures such as acetabular reconst ruct ion and femoroacetabular impingement .
M ATERIALS AND M ETHODS
t he dist ance bet w een it s ant er ior r im and symphysis pubis, w idt h of greater sciat ic notch, p r eau r icu l ar sul cu s, o b t u r at o r fo r am en , ischiopubic ram us and feat ures of ilium and pubis w ere considered for t he classificat ion of t he hip bones regarding gender.
M ethod of measurement used for volume of acetabulum (VA) :
The acetabular notch was packed w it h Plaster of Paris by dissolving t he Plaster of Paris in water. The rat io of Plaster of Paris and water was 3:1. A special t ype of piece of polyt hene paper (‘Press N Seal’) w as spread and sealed all over t he internal surface of t he acetabular cavit y. The acetabular cup was filled w it h water completely and covered w it h ‘Press N Seal’. A small hole was made w it h t he divider and enlarged w it h t he help of scissors, and empt ied t he water int o t he Graduated cylinder. The reading was noted.
Fig. 1: Acetabular notch packed w it h Plast er of Par is.
Th e p r esen t st ud y w as co n d uct ed i n t h e Depart m ent of Anat omy, Padm ashree Dr. D.Y. Pat il M edical College, Hospit al and Research Cent re, Pim pri, Pune. M at erial of t he st udy consisted of 110 human hip bones (60 males and 50 females). All t he bones w ere fully ossified (ad ul t ) and f ree f r om any pat h ol ogical o r congenital defect . The hip bones st udied w ere collected from t he various depart ment s of Dr. D.Y. Pat il M edical College, Pimpri, Pune, Dr. D.Y. Pat il College of Ayurved and Research Cent re, Pim pri, Pune and M IM ER’S M edical college, Talegaon, Pune. Volum e of acet abulum w as measured on t hese hip bones on bot h t he sides. Classificat ion of the bones regarding gender was carried out . The diameter of t he acetabulum and
Int J Anat Res 2014, 2(3):549-52. ISSN 2321-4287 551 RESULTS AND TABLES
Leena Khobragade, P. Vat salasw amy. A STUDY ON M ORPHOM ETRIC M EASUREM ENT OF VOLUM E OF ACETABULUM .
Fig. 3: M easurem ent of volum e of Acetabulum w it h ‘Press N seal’.
The data obtained for volume was analysed in the follow ing manner:
a) M easurement s of males w ere compared wit h measurement s of females.
b) M easurement s of right side w ere compared w it h measurement s of left side.
c) In m ales r ight side m easurem ent s w ere compared w it h left side measurement s.
d) In females right side measurement s w ere compared w it h left side measurement s.
e) M easurem ent s of right side in males w ere compared w it h measurement s of right side in females.
f ) M easurem ent s of left side in m ales w ere com pared w it h measurement s of left side in females.
The data obtained for volume was tabulated and analysed st at ist ically t o find M ean, Standard deviat ion (SD) and Range in bot h t he sexes and bot h t he sides. The result s w ere analysed statist ically, by unpaired St udent ’s ‘t ’ test . P value o f < 0.05 w as co n si der ed f o r St at i st ical significance, M ahajan [4 ]. Statistical analysis was done using SPSS (St at ist ical Package for t he Social Sciences) version 11 and M icrosoft Excel 2007.
Follow ing tables summarize t he observat ions and result s of t he present st udy.
Table 1: Vo lum e o f Acet abulum (VA) in M ale and Fem ale.
M ean S.D. Range
M ale 60 23.13 5.37 11-37
Female 50 17.88 3.12 12-27
Sex n Volum e (m l) P value
<0.0001
M ean S.D. Range
Right 51 20.55 4.96 12-34
Left 59 20.91 5.4 11-37
Side n Volume (ml) P value
>0.05
In t he present st udy, t he m ean VA in M ale > Fem ale. The difference is stat ist ically significant ( P < 0.0001 ).
Table 2: Vo lum e of Acet abulum (VA) on Right and Left sides.
The m ean VA on Left > Right . The difference is st at ist i-cally non- significant .
Table 3: Co m par iso n of Vo lum e of Acet abulum ( VA ) in M ale and Fem ale wit h r espect t o side.
In case of male, t he mean VA on Right > Left . The difference is st at ist ically non- significant (P>0.05).
In case of female,t he mean VA on Left > Right . The difference is st at ist ically non- significant (P>0.05).
The mean VA in M ale Right > Female Right . The difference isstat ist ically significant (P< 0.0001).
The mean VA in M ale Left > Female Left . The difference is stat ist ically significant (P < 0.001).
Graph 1:Co m par iso n of Vo lum e (VA) wit h respect t o sex and side in t ot al and subt o t al sam ple.
DISCUSSION
As a result t o get a better insight , t he present st udy was compared w it h t hat of other w orkers.
Tan et al [5] st udied fift y-five embalmed hips. The volum e of t he acet abulum w it hout t he labrum was 31.5 cm3 ; w it h t he labrum, it was
41.1 cm3 ( P < .0001 ). There was no side t o
-side difference in cont ribut ion of t he labrum t o either surface area or volume bet w een right and left hips. In t he present st udy, t he mean volume of acetabulum is 20.74 ml + 5.18( range 11-37). M ale (Right) Female (Right) M ale (Left) Female (Left)
M ean ±SD 23.58 4.71 17.4 2.81 22.79 5.87 18.36 3.39
Range 15 – 34 12-24 11 – 37 13 – 27
Int J Anat Res 2014, 2(3):549-52. ISSN 2321-4287 552 CONCLUSION
Conflicts of Interests: None
REFERENCES
Leena Khobragade, P. Vat salasw amy. A STUDY ON M ORPHOM ETRIC M EASUREM ENT OF VOLUM E OF ACETABULUM .
Volume of acetabulum is 23.13 + 5.37 ( range 11-37 ) ml in case of male and 17.88 + 3.12 (range 12-27)ml in case of female. In t he present st udy, t he m ean VA in M ale > Fem ale. The difference is stat ist ically significant (P< 0.0001 ). Present st udy also show ed t hat volum e w as greater on left side as compared t o right side, b ut t he d if f eren ce w as st at i st i call y no t significant .
Kordelle et al [6] ment ioned t he shape of t he acetabulum described by t he height , w idt h , dept h, acetabular volume and surface. The mean acetabular volume was 26.3 mm3 (range
16.0-45.4) .
Chung et al [7] states t hat if t he definit ion of acet abu l ar v o lu m e i s t h e dep t h o f t h e acetabulum t hat contains the femoral head, then it w ill increase after a Dega osteot omy. They believe t his definit ion t o be preferable w hen assessing pelvic surgery for acetabular deficiency of acetabular volume.
Table 4: Co m parisio n of Vo lum e o f Acet abulum wit h present st u dy.
M ean S.D. Range
1 Ta n V 5 55 31.5cm3 -
-2 Ko rd el l e J 6 32 26.3mm3 - 16.0-45.4
3 Ch un g CY 7 17 14.2 m l 6
-4 Prese nt st ud y 110 20.74ml 5.18 11-37
Study Sample size Volume
Sr. No.
Chibber et al [8] suggest t hat left limb is domi-nant . Therefore, t he dimensions of t he bones forming t he hip joint of left side should be more so as t o bear greater loading force on femur. St udy done by Chauhan et al [9] found t hat left hip joint dimensions w ere greater t han t he right yet t hey w ere st at ist ically insignificant . In t he present st udy also it is found t hat t he volume was greater on left side as compared to right side but was stat ist ically non significant .
Know ledge of t he anat omical parameters of t he acetabulum is of immence importance t o t he Ort hopaedic surgeons. Hip surgery being one of t hem requires more detailed know ledge, about t he complex acetabular measurement s in order t o fulfil t he need for verifying t he validit y of various surgical procedures under pract ice. The v o lu m e st u di ed o n acet abu l u m sh ow ed stat ist ically significant differences bet w een
males and females. St udies based on Volume of acetabulum are relat ively few in t he Literat ure, hence t he findings of t he present st udy can pr ovid e a guid eli ne f or f ur t her st ud ies on acetabulum. The present st udy hence provides measurement s of volume of acetabulum t hat w ould help t he anat omist s, ant hropologist s, ort hopaedicians, prost het ist s, radiologist s and forensic experts t o deliver excellent performance in t heir respect ive specialit ies.
ACKNOW LEDGEM ENT
1. Dr. V. R. M ysorekar, for m er head of t he depart m ent of Anat omy in various M edical colleges for his valuable suggest ions.
2. Dr. V. Ar o l e, Pr o f esso r & Head , Dep ar t m ent o f Anat om y, Padm ashree Dr. D.Y.Pat i l M edical College, Pim pri, Pune for her support and encouragem ent .
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