Correlation between coxa profunda and morphological parameters of acetabular coverage in a Japanese cohort: A CT study.

Abstract

Coxa profunda is generally considered an indicator of acetabular overcoverage. However, recent studies have opposed this view. The correlation between coxa profunda and acetabular overcoverage thus remains controversial. The purpose of this study was to investigate the prevalence of coxa profunda and the association between coxa profunda and acetabular coverage based on sex in Japanese subjects using computed tomography. We reviewed the computed tomography scans of 151 Japanese consecutive patients (302 hips) aged <50 years who underwent abdominopelvic computed tomography for symptoms unrelated to hip disease. Coxa profunda was diagnosed when the floor of the acetabular fossa touched or was medial to the ilioischial line. We measured the lateral center edge angle, acetabular roof obliquity angle, acetabular version, and anterior and posterior acetabular sector angles as parameters of acetabular coverage. Coxa profunda was observed in 45.7% of all subjects, and was more common in females (63.0%) than in males (29.5%). We found no significant differences in the incidence of coxa profunda among subjects with dysplasia, overcoverage, and normal coverage. Males with coxa profunda showed significantly greater lateral center edge angle, anterior acetabular sector angle, and lower acetabular roof obliquity angle, whereas anterior and posterior acetabular sector angles were greater in all subjects and females with coxa profunda. Coxa profunda showed poor sensitivity (57.7%) and specificity (56.8%) for detecting overcoverage in all subjects. Coxa profunda is a common radiographic feature in Japanese patients, especially in women. Coxa profunda may be less useful for diagnosing acetabular overcoverage because of its common occurrence with various hip morphologies and its poor specificity for detecting acetabular overcoverage. However, men with coxa profunda have greater acetabular coverage, so coxa profunda may contribute to acetabular coverage in men. We should take into account that coxa profunda may have different implications between the sexes.