[Biomechanical significance of the acetabular roof and its reaction to mechanical injury].
BACKGROUND
The introduction of morphometry into the quantitative analysis of the bone system and functional adaptation of acetabulum to mechanical damages and injuries enabled a relatively simple and acceptable examination of morphological acetabular changes in patients with damaged hip joints. Measurements of the depth and form of acetabulum can be done by radiological methods, computerized tomography and ultrasound (1-9).


OBJECTIVE
The aim of the study was to obtain data on the behaviour of acetabular roof, the so-called "eyebrow", by morphometric analyses during different mechanical injuries.


METHODS
Clinical studies of the effect of different loads on acetabular roof were carried out in 741 patients. Radiographic findings of 400 men and 341 women were analysed. The control group was composed of 148 patients with normal hip joints. Average age of the patients was 54.7 years and that of control subjects 52.0 years. Data processing was done for all examined patients.


RESULTS
On the basis of our measurements the average size of female "eyebrow" ranged from 24.8 mm to 31.5 mm with standard deviation of 0.93 and in men from 29.4 mm to 40.3 mm with standard deviation of 1.54. The average size in the whole population was 32.1 mm with standard deviation of 15.61. Statistical analyses revealed high correlation coefficients between the age and "eyebrow" size in men (r = 0.124; p < 0.05); it was statically in inverse proportion (Graph 1). However, in female patients the correlation coefficient was statistically significant (r = 0.060; p > 0.05). The examination of the size of collodiaphysial angle and length of "eyebrow" revealed that "eyebrow" length was in inverse proportion to the size of collodiaphysial angle (r = 0.113; p < 0.05). The average "eyebrow" length in relation to the size of collodiaphysial angle ranged from 21.3 mm to 35.2 mm with standard deviation of 1.60. There was no statistically significant correlation between the "eyebrow" size and Wiberg's angle in male (r = 0.049; p > 0.05) and female (r = 0.005; p > 0.05) patients. The "eyebrow" length was proportionally dependent on the size of the shortened extremity in all examined subjects. This dependence was statistically significant both in female (r = 0.208; p < 0.05) and male (r = 0.193; p < 0.05) patients. The study revealed that fossa acetabuli was forward and downward laterally directed. The size, form and cross-section of acetabulum changed during different loads. Dimensions and morphological changes in acetabulum showed some but unimportant changes in comparison to that in the control group. These findings are graphically presented in Figure 5 and numerically in Tables 1 and 2.


CONCLUSIONS
The study of spatial orientation among hip joints revealed that fossa acetabuli was forward and downward laterally directed; this was in accordance with results other authors (1, 7, 9, 15, 18). There was a statistically significant difference in relation to the "eyebrow" size between patients and normal subjects (t = 3.88; p < 0.05). The average difference of "eyebrow" size was 6.892 mm. A larger "eyebrow" was found in patients with normally loaded hip. There was also a significant difference in "eyebrow" size between patients and healthy female subjects (t = 4.605; p < 0.05). A larger "eyebrow" of 8.79 mm was found in female subjects with normally loaded hip. On the basis of our study it can be concluded that the findings related to changes in acetabular roof, the so-called "eyebrow", are important in diagnosis, follow-up and therapy of pathogenetic processes of these disorders.
Domazet
N
N
Karaburma Military Medical Centre, Belgrade.
Starović
D
D
Nedeljković
R
R
D000077:Acetabulum / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013314:Stress, Mechanical