Three-dimensional morphological analysis of true acetabulum in Crowe type IV hip dysplasia via standard-sized cup-simulated implantation

Acetabular reconstruction in Crowe type IV developmental dysplasia of the hip (DDH) can be a challenging procedure for surgeons. A high risk of acetabular revision has been reported to be associated with extremely small acetabular prostheses. However, to our knowledge, quantitative morphological and coverage evaluations of the true acetabulum in Crowe IV hips have been infrequently conducted. Useful bony landmarks for acetabular reconstruction can also facilitate satisfactory intraoperative implantation. The aim of the present study was to investigate the anatomical size, orientation angles, and 2/3-dimensional (2D/3D) coverage parameters of the true acetabulum in Crowe IV hips; evaluate the feasibility of standard cup (>44 mm) implantation at the true acetabulum in Crowe IV hips; and identify the optimal position and useful bony landmarks of the acetabular reaming center in Crowe IV hips.