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Acetabulum

The acetabulum (/ˌæsɪˈtæbjʊləm/; pl.: acetabula or acetabuli) is a cup-shaped socket located on the lateral aspect of the pelvis, formed by the convergence of the ilium, ischium, and pubis bones of the hip bone (os coxae). It serves as the socket for the head of the femur to form the hip joint, providing stability for weight-bearing and locomotion while allowing a wide range of motion.^[1] The acetabulum covers approximately 40% of the femoral head, with the fibrocartilaginous acetabular labrum deepening the socket and increasing its volume by about 33%.^[1]

Overview

Definition and Location

The acetabulum is the deep, cup-shaped socket of the hip joint, formed within the pelvis and serving as the site of articulation with the rounded head of the femur to constitute a multiaxial ball-and-socket synovial joint. This structure enables a wide range of motion while providing stability for weight transmission from the trunk to the lower limbs. The acetabulum develops at the junction of the three primary bones comprising the os coxae, or hip bone: the ilium superiorly, the ischium inferiorly and posteriorly, and the pubis anteriorly and inferiorly. These bones converge to create the acetabular cavity during growth, with fusion completing in early adulthood.^[1] Anatomically, the acetabulum occupies the lateral aspect of the pelvis, positioned below the iliopectineal line—which forms the anterior rim of the true pelvis—and inferior to the iliac crest. It lies anterior to the sacrum and slightly medial to the greater sciatic notch, integrating seamlessly into the pelvic girdle to support upright posture and bipedal locomotion. The acetabular opening orients inferolaterally, facing outward and downward at an average anteversion angle of 17° ± 6° relative to the coronal plane, which optimizes joint congruence and femoral head containment. In adults, the acetabulum exhibits an average depth of 22 ± 2 mm, sufficient to partially encompass the femoral head for joint stability. The lunate surface, a horseshoe-shaped articular region of hyaline cartilage lining the acetabulum, spans the superior, anterior, and posterior aspects, covering approximately 40% of the femoral head's surface area to facilitate load distribution during movement, enhanced by the fibrocartilaginous acetabular labrum which deepens the socket.^[1]

Function in Locomotion

The acetabulum forms the socket of the hip's ball-and-socket joint, enabling multi-axial motion that is essential for locomotion, including flexion and extension, abduction and adduction, and internal and external rotation. This design allows a typical range of motion of approximately 120° in flexion, 20° in extension, 45° in abduction, 30° in adduction, 30° in internal rotation, and 45° in external rotation.^[2] The acetabulum's hemispherical shape accommodates the femoral head, facilitating smooth articulation during activities such as walking and running. In terms of load-bearing, the acetabulum distributes compressive forces from the femoral head to the pelvic bones, supporting body weight and dynamic impacts during movement; peak forces can reach 5 to 8 times body weight during running, highlighting its role in efficient force transmission. This load distribution is crucial for maintaining pelvic stability and preventing excessive stress on surrounding tissues. The deep acetabular socket, reinforced by the labrum, enhances joint congruence and creates a suction-seal effect that resists subluxation, particularly under high loads.^[2]^[3] During the gait cycle, the acetabulum contributes to the stance phase by providing a stable base for weight acceptance and propulsion, while in the swing phase, it supports femoral head repositioning for stride advancement. Evolutionarily, the human acetabulum exhibits greater depth compared to quadrupeds, an adaptation that enhances stability and efficiency in bipedal locomotion by improving load transfer and reducing lateral sway. This deepened structure likely emerged in early hominins to facilitate upright walking and endurance activities.^[4]

Anatomy

Bony Components

The acetabulum is a cup-shaped socket formed by the confluence of three primary bones of the pelvis: the ilium, which contributes the superior portion; the ischium, providing the posteroinferior aspect; and the pubis, forming the anterior segment.^[1] These bones unite at the triradiate cartilage during childhood, a Y-shaped physeal structure that facilitates growth and eventual ossification, typically completing fusion between ages 15 and 17 with full maturation by 20 to 25 years.^[1] This tripartite bony architecture ensures a deep, stable enclosure for the femoral head, with the ilium and ischium each accounting for approximately 40% of the acetabular depth and the pubis contributing the remaining 20%.^[5] Central to the acetabulum's internal structure is the acetabular fossa, a non-articular depression at its base that lacks hyaline cartilage coverage and serves as an attachment site for the ligamentum teres.^[1] Surrounding this is the lunate surface, a horseshoe-shaped articular region along the acetabular rim, covered by cartilage and designed for direct contact with the femoral head; its thickness is greatest ventrally and cranially, tapering concentrically toward the periphery to optimize load distribution.^[1] Inferiorly, the acetabular notch interrupts the rim, creating a gap that is spanned by the transverse acetabular ligament in the mature skeleton, allowing neurovascular passage while maintaining structural integrity.^[1] The acetabulum's boundaries are defined by prominent bony margins that delineate its extent within the pelvis. The iliopectineal eminence marks the junction between the ilium and pubis, forming a subtle ridge that contributes to the acetabular roof.^[6] The arcuate line, a curved ridge on the ilium's inferior aspect, extends posteriorly and forms part of the pelvic brim, separating the greater pelvis from the acetabular cavity.^[7] Anteriorly, the pecten pubis, a sharp ridge along the superior ramus of the pubis, continues the line of the arcuate line and bounds the acetabulum superiorly.^[7] At the microstructural level, the subchondral bone beneath the acetabular cartilage exhibits variations in density that enhance its role in stress absorption and force transmission. This layer, composed of trabecular bone with type II collagen and glycosaminoglycans, supports the overlying articular surfaces in weight-bearing regions such as the superior acetabulum.^[1]^[8] These density gradients, observed through imaging and histological studies, adapt to biomechanical demands.^[9]

Articular Surfaces and Ligaments

The articular surfaces of the acetabulum primarily consist of the lunate surface, a horseshoe-shaped region covered by hyaline cartilage that articulates with the femoral head to form the hip joint.^[10] This hyaline cartilage, typically 1.7 to 2.7 mm thick, provides a smooth, low-friction interface for weight-bearing and movement, lubricated by synovial fluid secreted by the joint's synovial membrane.^[11] The non-articular acetabular fossa, located centrally within the acetabulum, contains loose connective tissue and fat but does not contribute directly to articulation.^[1] The acetabular labrum, a fibrocartilaginous ring attached to the acetabular rim except at the acetabular notch, enhances joint stability by deepening the acetabular socket and increasing its surface area for femoral head containment.^[12] This structure deepens the acetabulum by approximately 20-30%, distributing compressive forces and sealing the joint to retain synovial fluid.^[13] Composed of type I and II collagen fibers, the labrum transitions from hyaline-like cartilage near the articular surface to fibrous tissue peripherally, allowing flexibility while resisting shear stresses.^[14] The hip joint is reinforced by several key ligaments that stabilize the articulation and limit excessive motion. The iliofemoral ligament, the strongest of the hip ligaments and often Y-shaped, arises from the anterior inferior iliac spine and intertrochanteric line, providing anterior reinforcement against hyperextension.^[15] The pubofemoral ligament, extending from the pubic ramus to the intertrochanteric line, limits abduction and extension inferiorly.^[10] Posteriorly, the ischiofemoral ligament spirals from the ischial body to the greater trochanter and iliofemoral ligament, resisting internal rotation and adduction.^[16] The transverse acetabular ligament bridges the acetabular notch, completing the labral ring and serving as an attachment site for the ligamentum teres while transmitting some vascular supply to the joint.^[16] Enclosing the hip joint, the joint capsule comprises an outer fibrous layer and an inner synovial layer, attaching proximally to the acetabular rim and labrum, and distally to the femoral neck intertrochanteric line.^[1] The fibrous layer, thickened by the aforementioned capsular ligaments, provides tensile strength, while the synovial layer produces lubricating fluid and lines the intracapsular structures.^[10] A specialized reinforcement, the zona orbicularis, consists of circular fibers encircling the femoral neck like a collar, enhancing joint stability by resisting distraction and facilitating synovial fluid circulation.^[17]

Blood Supply and Innervation

The arterial supply to the acetabulum primarily derives from the obturator artery, which arises from the anterior division of the internal iliac artery and gives off an acetabular branch that enters the acetabulum through the acetabular notch to nourish the weight-bearing region.^[18] Additional contributions come from the medial and lateral circumflex femoral arteries, branches of the profunda femoris artery, which anastomose around the hip joint capsule to supply the peripheral aspects of the acetabulum via capsular branches.^[19] The inferior gluteal artery, from the anterior division of the internal iliac artery, provides further supply to the posteroinferior acetabulum, while the superior gluteal artery contributes to the superior region through deep branches.^[20] Venous drainage of the acetabulum follows the arterial pathways, with veins accompanying the obturator and gluteal arteries draining into the internal iliac vein, and those from the circumflex femoral arteries converging into the external iliac vein via the femoral vein.^[21] Innervation of the acetabulum and hip joint is sensory and arises from articular branches of the femoral nerve (L2-L4), which supplies the anterior capsule; the obturator nerve (L2-L4), targeting the inferomedial and anterosuperior regions; and the sciatic nerve (L4-S3), contributing to the posterior capsule for proprioception and pain referral.^[22] The nerve to the quadratus femoris (L4-S1) also provides consistent posterior innervation, particularly to the inferior half of the capsule.^[23] Lymphatic drainage from the acetabulum proceeds through pelvic vessels to the internal iliac lymph nodes, which relay to the common iliac and lumbar aortic nodes.^[24]

Development

Embryonic Formation

The embryonic formation of the acetabulum begins during the early stages of human gestation, originating from mesenchymal condensations within the pelvic girdle primordium. Around week 4 of development (embryonic day 28), lower limb buds emerge at the lumbar and sacral segments, accompanied by the initial mesenchymal condensations that delineate the future iliac, ischial, and pubic processes.^[25] These condensations represent the acetabular primordium, appearing as part of the broader pelvic blastema between weeks 4 and 5, setting the foundation for the hip joint cavity.^[26] By week 6, chondrification initiates in these mesenchymal masses, with distinct centers forming around the prospective acetabulum: the ilium chondrifies first in the upper blastema, contributing to the superior dome, while the ischium and pubis develop from the lower blastema, forming the posterior wall and anterior wall, respectively.^[27] These centers grow radially and begin to converge, establishing the shallow depression characteristic of the early acetabulum by week 7.^[25] At this stage, the three chondrification centers meet at the triradiate cartilage, a Y-shaped structure that serves as the growth junction for the acetabulum, ensuring coordinated expansion of the ilium, ischium, and pubis.^[26] Genetic regulation plays a critical role in this patterning, with Hox genes (particularly from the HOXB cluster) directing the anterior-posterior identity of the pelvic mesenchyme and influencing joint specification in the acetabulofemoral region.^[28] Concurrently, bone morphogenetic protein (BMP) signaling pathways mediate mesenchymal condensation and chondrogenesis, promoting the differentiation of progenitor cells into the hyaline cartilage model that precedes ossification.^[29] By week 8, the initial hyaline cartilage anlage is fully established, enclosing the developing femoral head and providing the template for subsequent fetal growth.^[25] This embryonic phase culminates in a structurally defined acetabulum, ready for refinement during the fetal period.

Postnatal Growth and Ossification

Following birth, the acetabulum undergoes significant postnatal maturation through the ossification and fusion of its bony components, which are initially separated by cartilage. The primary ossification centers for the ilium, ischium, and pubis are well-developed at birth, with the ilium already substantially ossified, while the ischium and pubis continue minor early postnatal consolidation from their prenatal origins.^[25] Secondary ossification centers emerge around 8-12 years of age, including the os acetabuli anteriorly and additional centers at the ilium-ischium and superior acetabular regions. The triradiate cartilage, a key Y-shaped growth plate at the acetabular floor, begins ossification around 10-11 years and fuses completely by mid-adolescence, typically 13-14 years in females and 15-16 years in males, marking the integration of the three pelvic bones.^[30] Full acetabular closure, incorporating the posterior wall and secondary centers, occurs by 16-18 years, completing the mature socket structure.^[25] Postnatal growth of the acetabulum involves a combination of appositional growth along the periosteum, which expands the bony margins, and endochondral ossification at the triradiate cartilage, where chondrocytes hypertrophy and are replaced by bone, deepening the socket. This process increases acetabular depth and coverage progressively, with rapid expansion in the first few years slowing until a pubertal spurt. Mechanical loading plays a critical role in shaping this development; the onset of independent walking around 12 months introduces weight-bearing forces that stimulate chondral modeling and acetabular remodeling, promoting proper femoral head containment and preventing dysplasia if loading is balanced.^[31]^[32] Sexual dimorphism emerges during puberty, influenced by hormonal factors such as estrogen and testosterone, resulting in a deeper acetabulum in males compared to females, alongside broader pelvic dimensions in males that enhance load distribution.^[33] In adulthood, aging beyond 50 years leads to degenerative changes, including subchondral sclerosis—thickening and hardening of the bone beneath the cartilage due to increased mechanical stress and cartilage loss—and progressive labral degeneration, characterized by fraying and tears at the acetabular rim, which compromises joint stability and contributes to osteoarthritis risk.^[34]^[35]

Comparative Anatomy

Variations in Mammals

The acetabulum exhibits notable structural variations across mammalian species, primarily reflecting adaptations to diverse locomotor strategies such as quadrupedalism, arboreal brachiation, and bipedalism. These differences manifest in socket depth, bony contributions, orientation, and internal features like the cotyloid fossa, influencing joint stability, range of motion, and load distribution. Comparative studies highlight how evolutionary pressures shape the acetabulum to optimize function in each group's habitual posture and movement patterns.^[36] In quadrupedal mammals like dogs, the acetabulum is characterized by a deep socket that supports agile, high-speed locomotion while maintaining joint integrity under dynamic forces. The ischium provides a substantial contribution, forming nearly the entire acetabular fossa, which is medioventrally depressed and features rough surfaces with foramina for vascular and ligamentous attachments. This configuration enhances the joint's capacity for flexion and extension during rapid directional changes, with the deeper structure relative to smaller felids aiding in shock absorption without compromising mobility.^[37]^[38] Among non-human primates such as chimpanzees, the acetabulum displays an intermediate depth and shape suited to mixed arboreal and terrestrial activities, including brachiation and knuckle-walking. Geometric morphometric analyses reveal that chimpanzee acetabula share similarities with those of gorillas, featuring broader ventral-cranial regions and less pronounced dorsal coverage compared to humans, which facilitates greater hip abduction and rotation essential for below-branch suspension. The orientation is more laterally facing than in humans, reducing the emphasis on vertical load-bearing and allowing for enhanced mobility in arboreal environments.^[39]^[40] Large herbivores like horses possess a reinforced acetabulum adapted for supporting immense body weight during sustained quadrupedal gait and galloping. The socket is deep, with the cotyloid fossa prominently positioned near the center and containing numerous foramina that accommodate nutrient vessels and the round ligament, bolstering overall durability. This structure, combined with contributions from the ilium, ischium, and pubis, ensures robust articulation with the femoral head, minimizing luxation risk under high compressive loads.^[37]^[41] In humans, the acetabulum is uniquely deeper and more vertically oriented, with a ventral and caudal tilt that optimizes stability for exclusive bipedalism. This configuration, angled approximately 20–40 degrees off vertical, aligns the joint for efficient weight transfer through the lower limbs, enhancing balance and stride efficiency while the elongated dorso-cranial lunate surface provides superior femoral head coverage. Such adaptations distinguish the human acetabulum from other mammals, prioritizing upright posture over versatile quadrupedal or arboreal motion.^[4]^[42]^[39]

Features in Reptiles and Birds

In reptiles and birds, belonging to the sauropsid lineage, the acetabulum exhibits distinct morphological features adapted to diverse locomotor strategies, differing from the imperforate, deeper socket typical in mammals. The sauropsid acetabulum generally forms at the confluence of the ilium, ischium, and pubis, but often features a perforation known as the foramen acetabuli, which allows passage of the acetabular ligament to the femoral head and may facilitate abdominal muscle or nerve transit in certain taxa.^[43]^[44] In lepidosaurian reptiles such as lizards, the acetabulum is typically imperforate and shallower, forming a simple oval cavity that supports a sprawling gait with limbs positioned laterally to the body. This configuration, with reduced depth and broader articular surfaces, accommodates low-speed terrestrial locomotion and allows space for the passage of abdominal muscles via adjacent structures like the obturator foramen in the pubis, below the acetabular margin. Pubic and ischial elements extend as rods contributing to the pelvic floor, enhancing flexibility for undulating body movements.^[45] In contrast, archosaurian reptiles like crocodilians display a perforate acetabulum formed exclusively by the ilium and ischium, excluding the pubis, which remains mobile for ventilatory and buoyancy adjustments during aquatic propulsion. This deeper socket, oriented more ventrally in some species, provides stability for powerful tail-driven swimming while permitting a spectrum of limb postures from sprawling to erect. Birds exhibit a fully perforate acetabulum, circular in outline and fused to the ilium as part of the reinforced synsacrum, with the pubis and ischium apposed but reduced in length to minimize weight. The socket's floor is broadest anteriorly, featuring a fibrocartilaginous labrum and an antitrochanter—a bony prominence on the caudodorsal rim—that prevents femoral abduction and absorbs stresses during bipedal or flight-related locomotion. A supracetabular crest overhangs the acetabulum, distributing forces from the vertically oriented femur and enhancing pelvic girdle rigidity for aerial adaptations.^[43]^[47] Evolutionarily, the sauropsid acetabulum lacks the triradiate Y-shaped cartilage of mammals, instead undergoing ossification via intramembranous processes in the pelvic bones, with the perforation arising from secondary loss of cartilaginous tissue in the acetabular interzone during embryogenesis. This developmental mechanism, driven by Wnt ligand susceptibility in the hip joint's mesenchymal layers, emerged in archosaurian lineages and supports efficient parasagittal limb excursion, linking to enhanced respiratory-locomotor coupling in birds and their dinosaurian ancestors.^[44]

Clinical Aspects

Fractures and Trauma

Acetabular fractures result primarily from high-energy trauma, such as motor vehicle collisions (MVCs) where the dashboard impacts the flexed knee, transmitting force through the femur to fracture the acetabulum.^[48] Falls from significant heights or pedestrian strikes also contribute, often leading to complex intra-articular disruptions. Approximately 80% of these fractures involve the posterior structures, including the posterior wall or column, due to the typical axial loading and rotational forces in such injuries.^[49] The Judet-Letournel classification system remains the standard for categorizing acetabular fractures into elementary and associated patterns based on involvement of the anterior and posterior columns and walls.^[50] Elementary fractures include the posterior wall (most common, ~25%), posterior column (~3-5%), anterior wall, anterior column, and transverse types, each isolating a single structural component. Associated fractures combine elements, such as transverse with posterior wall (~20%), T-shaped, anterior column with posterior hemitransverse, posterior column with posterior wall, and both columns (most complex, often leaving no intact acetabular segment).^[48] Immediate complications of acetabular fractures include substantial retroperitoneal hemorrhage, with potential blood loss up to 2 liters, often requiring transfusion in up to 35% of cases.^[48] Sciatic nerve injury occurs in 10-20% of patients, particularly with posterior wall fractures and associated hip dislocations, potentially leading to foot drop or sensory deficits.^[51] Avascular necrosis of the femoral head is a serious risk (up to 10-40% in high-risk patterns), arising from disruption to the retinacular vessels and medial femoral circumflex artery, which may compromise femoral head perfusion as detailed in blood supply considerations.^[48] Acute management begins with advanced imaging, where computed tomography (CT) is essential for detailed fracture mapping, displacement assessment (>2 mm indicates instability), and surgical planning.^[48] For displaced or unstable fractures, open reduction and internal fixation (ORIF) is the preferred intervention, ideally performed within 3-5 days to restore articular congruity and minimize complications, using approaches like the Kocher-Langenbeck for posterior patterns.^[48]

Congenital and Acquired Disorders

Congenital disorders of the acetabulum primarily involve developmental dysplasia of the hip (DDH), a condition characterized by abnormal development of the hip joint, including a shallow or underdeveloped acetabulum that fails to adequately cover the femoral head.^[52] This dysplasia results in insufficient femoral head containment, often leading to subluxation or dislocation if untreated. The prevalence of DDH is approximately 1-2 per 1,000 live births, though true hip instability may occur in up to 15-20 per 1,000 cases.^[52] A key radiographic indicator is the center-edge (CE) angle of Wiberg, where values less than 20° signify acetabular dysplasia and inadequate coverage.^[53] Risk factors for DDH include breech presentation during pregnancy, which increases mechanical stress on the hip joint, and genetic predisposition, such as a positive family history that elevates recurrence risk in siblings by up to 10-fold.^[54] The condition shows a marked female predominance, with a female-to-male ratio ranging from 4:1 to 8:1, attributed to hormonal and biomechanical differences during fetal development.^[55] Diagnosis in infants under 6 months relies on ultrasound, which assesses acetabular depth and femoral head position dynamically, while X-rays are preferred for children over 6 months once the femoral head ossifies.^[56] Early detection is critical, as untreated DDH can progress to premature osteoarthritis in adulthood. Treatment for mild to moderate DDH in infants typically involves the Pavlik harness, a soft abduction device that maintains hip flexion and abduction to promote acetabular remodeling, with success rates exceeding 90% when initiated before 6 months of age.^[57] For older children or severe cases, closed or open reduction with spica casting or pelvic osteotomy may be required to deepen the acetabulum and stabilize the joint.^[57] Acquired disorders affecting the acetabulum include Legg-Calvé-Perthes disease (LCPD), an idiopathic avascular necrosis of the femoral head epiphysis in children aged 4-10 years, which secondarily alters acetabular morphology.^[58] The initial avascular insult leads to femoral head deformity, prompting adaptive changes in the acetabulum, such as cranial retroversion and reduced coverage, increasing long-term instability risk.^[59] These acetabular alterations, including shallowing and lateralization, contribute to hinge abduction and early degenerative changes.^[60] LCPD affects boys more commonly (ratio 4-5:1) and is unilateral in 85% of cases, with treatment focusing on containment via bracing or surgery to prevent acetabular remodeling failure.^[58] Osteoarthritis (OA) of the hip represents a major acquired pathology, where acetabular degeneration often stems from labral tears that disrupt joint stability and accelerate cartilage loss.^[3] Labral tears, common in up to 66% of symptomatic hips, cause abnormal load distribution on the acetabular rim, leading to progressive subchondral bone sclerosis, cyst formation, and joint space narrowing.^[61] In adults, diagnosis involves X-rays to assess joint space and osteophytes, supplemented by MRI to evaluate labral integrity and chondral damage.^[62] For end-stage OA with severe acetabular involvement, total hip arthroplasty (THA) is the definitive treatment, replacing the damaged acetabulum and femoral head to restore function, with success rates over 90% in pain relief and mobility at 10 years post-surgery.^[63]

History and Etymology

Anatomical Naming

The term "acetabulum" originates from Latin, where it denotes a small cup or vessel specifically for holding vinegar, derived from "acetum" meaning vinegar and the diminutive suffix "-abulum" indicating a small container.^[64]^[65] This nomenclature was applied anatomically in antiquity to describe the cup-shaped socket of the hip joint due to its deep, rounded form, with the term used by Roman physicians as a liquid measure of approximately 68 milliliters.^[64] In ancient Greek, a corresponding synonym was "kotyloides," meaning cup-shaped or socket-like, which directly influenced the modern anatomical term "cotyloid" as in "cotyloid cavity," an alternative name for the acetabulum emphasizing its resemblance to a wide-mouthed cup.^[65] This Greek root "kotýlē" (cup) underscores the shared descriptive focus on the structure's concavity across classical languages.^[65] The terminology for the acetabulum was formalized through the Nomina Anatomica, beginning with the Basle Nomina Anatomica in 1895, which standardized Latin anatomical names by correcting earlier barbaric forms like "acceptabulum" to the classical "acetabulum" and reducing synonymous variants.^[66] Subsequent revisions, such as the Terminologia Anatomica of 1998 and its 2019 update, maintained this Latin base while incorporating bilingual Latin-English conventions for international use in medical education and literature.^[66] Culturally, the name evokes an everyday ancient Roman household item: a small, open-topped earthenware or metal cup placed on dining tables for dipping food into vinegar, often featuring two handles and a short foot, which mirrored the acetabulum's functional shape as a receptive socket.^[67] Roman physicians also employed the acetabulum as a standardized liquid measure, approximately 68 milliliters, linking domestic utility to early medical precision.^[64]

Key Historical Descriptions

The earliest known descriptions of the acetabulum appear in ancient Greek medical literature. Hippocrates, around 400 BCE, discussed injuries to the hip socket in the context of fractures and dislocations, often classifying acetabular damage under the broader term of "hip dislocations" due to the challenges in clinical differentiation at the time.^[68]^[69] In the 2nd century CE, Galen advanced this understanding through dissections primarily on animals, detailing the pelvic articulations and describing the acetabulum as a deep, tough cartilaginous socket that receives the femoral head, emphasizing its role in joint stability.^[70]^[71] The Renaissance brought more precise visual representations of the acetabulum. In 1543, Andreas Vesalius published De Humani Corporis Fabrica, featuring detailed woodcut illustrations of the pelvic bones and acetabular structure derived from human cadavers, correcting earlier inaccuracies in Galenic anatomy and establishing a foundation for modern anatomical study.^[72]^[73] By the 19th century, anatomical investigations focused on associated structures. Sir Astley Cooper provided the first comprehensive autopsy-based description of an acetabular fracture with central dislocation in 1818, highlighting the socket's vulnerability to trauma and its implications for joint function.^[69] In the 1820s, French anatomist Hippolyte Cloquet contributed detailed studies on the ligaments surrounding the acetabulum, including their attachments and roles in reinforcing the hip joint capsule.^[74] Werner Spalteholz's Handatlas der Anatomie des Menschen (first edition 1896, with updates through the 1900s) illustrated the ossification processes of the acetabulum, showing the triradiate cartilage and sequential fusion of ilium, ischium, and pubis contributions.^[75] Twentieth-century developments emphasized clinical and developmental aspects. In the 1960s, Émile Letournel, collaborating with Robert Judet, introduced a seminal classification system for acetabular fractures based on radiographic patterns, which categorized injuries into elementary and associated types to guide surgical intervention.^[49]^[76] Modern advances in the 1970s included the introduction of computed tomography (CT) imaging, which by the late decade enabled three-dimensional visualization of acetabular fractures and morphology, surpassing plain radiographs in detecting intra-articular fragments and wall disruptions.^[77]^[78]

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Mar 15, 2017 · The first indication of the development of the pelvis occurs around embryonic day 28, when the lower limb buds begin to develop at the lumbar ...
[25]
Normal Hip Embryology and Development | Musculoskeletal Key
Nov 30, 2016 · The fetal phase, from 8 weeks to birth, consists of refinement of the vascular supply, ossification of the diaphysis of long bones, and ...
[26]
Timeline human development - UNSW Embryology
Week 1 to Week 8 (GA 10)are considered the embryonic period of development. Week 9 to week 37 (GA 11-39) or birth are considered the fetal period of development ...Introduction · First Trimester · Second Trimester · Human Systems
[27]
Current knowledge on the genetic background of developmental ...
Developmental dysplasia of the hip (DDH) represents a morphological abnormality characterized by the incongruity of femoral head and acetabulum.
[28]
BMP Signaling and Skeletogenesis - PubMed
... roles in delivering the extracellular signals ... Hox genes is regulated by BMPs. It is suggested that Hox proteins play an important role in the BMP pathway.
[29]
Ossification centers of the hip and pelvis | Radiology Reference Article
Jan 12, 2024 · ilium: appears at 8 weeks in utero; fuses at 7-9 years · ischium: appears at 4-6 months in utero; fuses at 7-9 years · pubis: appears at 4-6 ...
[30]
[PDF] Developmental Hip Dysplasia - and Dislocation
Growth of the acetabular cartilage occurs by means of interstitial growth within the cartilage and appositional growth under the peri- chondrium. This fact ...<|separator|>
[31]
Age at Onset of Walking in Infancy Is Associated With Hip Shape in ...
One factor known to be closely related to hip development throughout childhood is mechanical loading of the skeleton during every day physical activity. The ...
[32]
Subchondral Sclerosis: Hip, Cyst Formation, and More - Healthline
Jan 17, 2019 · Subchondral sclerosis usually appears in the later stages of osteoarthritis. It doesn't give you symptoms separate from those of osteoarthritis.
[33]
Acetabular rim degeneration: a constant finding in the aged hip
Acetabular rim degeneration is a constant finding in the aged hip, which seems to be triggered by femoroacetabular impingement.
[34]
An approach to Comparative Anatomy of the Acetabulum from ...
Jun 30, 2011 · We dissected the hip joints of 16 species and compared the anatomical features of the soft tissue from the respective acetabula. In addition, a ...
[35]
[PDF] Comparative anatomy of the coxofemoral articulation of the ... - CORE
The acetabulum of the ox was comparatively shallower, an acetabular notch was present in the acetabulum of the dog, ox and horse. A second notch and a ...<|separator|>
[36]
Acetabular Fossa - an overview | ScienceDirect Topics
The acetabulum in cats is shallower than in dogs. The most important stabilizers of the hip joint are the teres ligament, the joint capsule, and the transverse ...
[37]
https://core.ac.uk/download/pdf/33367437.pdf
[38]
Acetabular orientation, pelvic shape, and the evolution of hominin ...
The ventral and caudal orientation of the acetabulum in humans is distinct from the morphology of other extant primates (Fig. 1), which appear to exhibit more ...
[39]
Pelvic Limb – CVM Large Animal Anatomy
Figure 4-6 Equine left acetabulum, ventral lateral view. A, Articular surface of the acetabulum (acetabular fossa); g, shallow groove for the accessory ...
[40]
Acetabular orientation, pelvic shape, and the evolution of hominin ...
The orientation of the acetabulum may also differ, plausibly related to differences in load transmission during upright posture and habitual bipedal locomotion ...Missing: vertical | Show results with:vertical
[41]
(PDF) The Avian Acetabulum: Small Structure, but Rich with ...
Dec 12, 2023 · Here, I present anatomical evidence from the acetabulum and its important appurtenances, the supracetabular crest and the antitrochanter, that ...
[42]
Morphogenetic mechanism of the acquisition of the dinosaur ... - NIH
Oct 17, 2018 · The avian perforated acetabulum develops via a secondary loss of cartilaginous tissue in the acetabular region.
[43]
The Osteology of the Reptiles/Chapter 4 - Wikisource
Sep 2, 2024 · The inner end in some lizards is broad and perforated (Fig. 99 c) ... It may be added that the acetabulum of all dinosaurs is perforate, as in the ...
[44]
The evolution, development and skeletal identity of the crocodylian ...
Unlike most tetrapods, in extant crocodylians the acetabulum is formed by only two of the three skeletal elements that constitute the pelvis, the ilium, ...
[45]
[PDF] Gross anatomical studies on the pelvic girdle of blue and yellow ...
Oct 24, 2019 · The acetabulum was formed by ilium, ischium and pubis in blue and yellow macaw as in other birds. It was perforated and circular in outline (Fig ...<|separator|>
[46]
Acetabular Fractures - StatPearls - NCBI Bookshelf
The acetabulum divides into an anterior and posterior column. The anterior column contains the anterior half of the iliac wing that is contiguous with a pelvic ...Missing: relative | Show results with:relative
[47]
Judet and Letournel classification for acetabular fractures
Mar 15, 2025 · The Judet and Letournel classification divides acetabular fractures into ten major fracture patterns, five simple patterns and five complex patterns.Classification · Radiographic features
[48]
Letournel Classification for Acetabular Fractures - PubMed Central
He divided acetabular fractures into 10 subtypes, five elementary patterns and five associated patterns (including more than one elementary pattern).
[49]
Sciatic nerve injury after acetabular fractures: a meta-analysis of ...
Feb 16, 2022 · The incidence of sciatic nerve injury associated with fractures of the acetabulum ranges from 10 to 30% [1, 2], whereas iatrogenic palsy has ...
[50]
Reconstruction of the Acetabulum in Developmental Dysplasia ... - NIH
Hip instability during infancy usually resolves within the first few weeks after birth without treatment. The reported incidence of DDH is 1-2 per 1000 newborns ...Surgical Technique · Low Hip Dislocation / Crowe... · ComplicationsMissing: prevalence causes
[51]
What Are the Reference Values and Associated Factors for Center ...
Wiberg [54] originally declared center-edge angle < 20° as pathologic, whereas the upper thresholds vary from > 40° [8, 9, 48] to > 45° [18, 31]. For studies on ...
[52]
Associations between risk factors and developmental dysplasia of ...
Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH.
[53]
The Epidemiology and Demographics of Hip Dysplasia - PMC - NIH
A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%).
[54]
Developmental Dysplasia of the Hip - StatPearls - NCBI Bookshelf
May 4, 2024 · Femoral head nuclei usually appear between 4 and 6 months, ranging from 1.5 to 8 months, so x-ray is the preferred diagnostic modality over the ...
[55]
Developmental dysplasia of the hip: What has changed in the last 20 ...
We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.
[56]
Legg-Calve-Perthes Disease - StatPearls - NCBI Bookshelf
Legg-Calve-Perthes disease (LCPD) is idiopathic osteonecrosis or idiopathic avascular necrosis of the capital femoral epiphysis of the femoral head.
[57]
The acetabulum in healed Legg–Calvé–Perthes disease is cranially ...
Feb 7, 2020 · After skeletal maturity, hips with healed Legg–Calvé–Perthes disease have shallower and more cranially retroverted acetabula, with globally reduced coverage of ...
[58]
The acetabulum in Perthes' disease: a prospective study of 123 ...
Perthes' disease leads to an enlargement and lateralisation of the femoral head, thereby altering the force transmission from the femoral head to the acetabulum ...
[59]
Hip Osteoarthritis: Etiopathogenesis and Implications for Management
Sep 26, 2016 · Acetabular labral tears are very common, estimated to be present in 66% of people with mechanical hip pain [90] and roughly 39% of the ...
[60]
Hip arthroscopy and osteoarthritis: Where are the limits and ...
Oct 16, 2015 · When hip arthroscopy is performed in advanced stages of arthritis, significant degenerative damage to the labrum and to the articular cartilage ...
[61]
Total Hip Arthroplasty Techniques - StatPearls - NCBI Bookshelf - NIH
THA provides reliable outcomes for patients suffering from end-stage degenerative hip osteoarthritis (OA), specifically pain relief, functional restoration, and ...
[62]
Musculoskeletal etymology: What's in a name? - PMC
The cup-like socket of the hip joint has been named as 'acetabulum', which means a small vessel or cup for vinegar (Fig. 1b). ... The acetabulum was used as a ...
[63]
Acetabulum - Clinical Anatomy Associates Inc.
Jun 1, 2018 · The word acetabulum is formed by the combination of the Latin root [acetum], meaning "vinegar", and the Latin suffix [-abulum] a diminutive ...<|separator|>
[64]
Nomina anatomica-unde venient et quo vaditis? - PMC
Apr 5, 2024 · Attempts of standardisation anatomical terms during the last 2 centuries—the Nomina anatomica. In the introduction to the Basle Nomina anatomica ...
[65]
LacusCurtius • Acetabulum (Smith's Dictionary, 1875)
### Summary of Acetabulum as Roman Household Item and Relation to Anatomical Term
[66]
Instruments of Reduction by Hippocrates
... acetabulum of the hip-joint. This bone is articulated somewhat obliquely, but less so than the humerus. The ischium is united to the great vertebra ...
[67]
Fractures of the acetabulum: from yesterday to tomorrow
Sep 22, 2020 · Four centuries after Homer, Hippocrates described injuries around the acetabulum under the common term “hip dislocations” [5] because it was ...
[68]
[PDF] Ancient Textual Sources on Ligamentum Teres
«The femur itself bends outward and forward; its head is a round epiphysis which gives origin to ligament. (νεῦρον) inserted in the acetabulum of the hip-joint.
[69]
[PDF] Galen on anatomical procedures [electronic resource]
anatomy. The dissection scene on the front of this jacket illustrates Galen demonstrating on a pig. Itjirst appeared on the title page of the Giunta edition.
[70]
History - SpringerLink
Feb 14, 2014 · The contribution of Vesalius to the knowledge of the bony pelvis as presented in “De Fabrica” was restricted to pictures of the os sacrum and of ...
[71]
Historical Anatomies on the Web: Andreas Vesalius Home
Andreas Vesalius' De corporis humani fabrica libri septem, featuring Vesalius performing a dissection in a crowded anatomical theatre.Missing: acetabulum | Show results with:acetabulum
[72]
[PDF] Eponymic Structures in Human Anatomy - Semantic Scholar
Rosenmuller, Johann Christian, in 1820 he was appointed. Professor of anatomy and surgery in University of Leipsic. (drawings in works are by himself), 1771?
[73]
Fractures of the Acetabulum - SpringerLink
Introduction: History and Development of Our Methods of Classification and Treatment of Acetabular Fractures. Emile Letournel, Robert Judet, Reginald A.
[74]
The History of Werner Spalteholz's Handatlas Der Anatomie Des ...
Werner Spalteholz's Handatlas der Anatomie des Menschen is one of the most elegantly illustrated anatomical atlases of all time.Missing: handbuch ossification acetabulum
[75]
CT of acetabular fractures: comparison with conventional radiography
CT was more sensitive than plain radiography in detecting fractures involving the sacrum, quadrilateral surface, acetabular roof, and posterior acetabular lip.
[76]
Milestones in CT: Past, Present, and Future - PMC - NIH
In 1971, the first patient CT exam by Ambrose and Hounsfield paved the way for not only volumetric imaging of the brain but of the entire body.