Research Articles

The Association between Acetabular Fracture and Acetabular Retroversion: A Cross-Sectional Case-Control Study

Abstract

Background: As previously demonstrated, acetabular fracture type can vary depending on acetabular version. However, there is limited research on the prevalence of acetabular retroversion (AR) in patients with acetabular fracture; hence, this study aims to investigate the association between AR and acetabular fracture.
Methods: In this case-control study, 197 male and female patients were selected (103 patients with acetabular fracture and 94 patients without acetabular fracture). Data were extracted by interview and review of the medical records. The acetabular version was measured by computed tomography (CT) scan using the central axial cut. The data were analyzed and the results were reported to be significant at P < 0.05.
Results: The mean central version angle was lower in the group with acetabular fracture compared to the other group (11.64° ± 9.19° vs. 16.27° ± 6.37°; P < 0.001). There were more retroverted acetabula in the group with fractures than in the group with intact acetabulum (38% vs. 20%; P = 0.005). It was found that acetabular version increased with age, and there was a correlation between age and acetabular version (r = 0.148; P = 0.051). Furthermore, retroverted acetabula were more prone to posterior-type acetabular fractures; 32% of fractures in retroverted acetabula were posterior type, while only 18% of fractures in anteverted acetabulum were posterior type (P = 0.021).
Conclusion: This study showed an association between acetabular fracture and AR. The prevalence of retroverted acetabula in patients with acetabular fracture was greater than in traumatic patients with intact acetabula. Posterior type fractures were more prevalent in patients with retroverted acetabula than in those with anteverted ones.

1. Lundin N, Huttunen TT, Berg HE, Marcano A, Felländer-Tsai L, Enocson A. Increasing incidence of pelvic and acetabular fractures. A nationwide study of 87,308 fractures over a 16-year period in Sweden. Injury. 2021;52(6):1410-7. doi: 10.1016/j.injury.2021.03.013. [PubMed: 33771345].
2. Chen CY, Hsu CJ, Lin TL, Chen HT, Tsai CH. Acetabular Fractures with Central Hip Dislocation: A Retrospective Consecutive 50 Case Series Study Based on AO/OTA 2018 Classification in
Midterm Follow-Up. Biomed Res Int. 2021;2021:6659640. doi: 10.1155/2021/6659640. [PubMed: 34568493]. [PubMed Central: PMC8463190].
3. Rinne PP, Laitinen MK, Huttunen T, Kannus P, Mattila VM. The incidence and trauma mechanisms of acetabular fractures: A nationwide study in Finland between 1997 and 2014. Injury.
2017;48(10):2157-61. doi: 10.1016/j.injury.2017.08.003. [PubMed: 28807429].
4. Del Río J, Garín A, Acuña I, Villalón I, Lara J. Morphological abnormalities of the hip in acetabular fractures. Trauma Case Rep. 2020;25:100271. doi: 10.1016/j.tcr.2019.100271. [PubMed: 31879700]. [PubMed Central: PMC6920112].
5. Tönnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81(12):1747-70. doi: 10.2106/00004623-199912000-00014.
[PubMed: 10608388].
6. Klasan A, Neri T, Sommer C, Leie MA, Dworschak P, Schofer MD, et al. Analysis of acetabular version: Retroversion prevalence, age, side and gender correlations. J Orthop Translat. 2019;18:
7-12. doi: 10.1016/j.jot.2019.01.003. [PubMed: 31508302]. [PubMed Central: PMC6718923].
7. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003(417):112-20. doi:
10.1097/01.blo.0000096804.78689.c2. [PubMed: 14646708].
8. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro- acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am. 2003;85(2):278-86. doi: 10.2106/00004623-200302000-00015. [PubMed: 12571306].
9. Lerch TD, Todorski IAS, Steppacher SD, Schmaranzer F, Werlen SF, Siebenrock KA, et al. Prevalence of Femoral and Acetabular Version Abnormalities in Patients With Symptomatic Hip Disease: A Controlled Study of 538 Hips. Am J Sports Med. 2018;46(1):122-34. doi: 10.1177/0363546517726983. [PubMed: 28937786].
10. Jamali AA, Mladenov K, Meyer DC, Martinez A, Beck M, Ganz R, et al. Anteroposterior pelvic radiographs to assess acetabular retroversion: high validity of the "cross-over-sign". J Orthop Res. 2007;25(6):758-65. doi: 10.1002/jor.20380. [PubMed: 17343286].
11. Werner CM, Copeland CE, Ruckstuhl T, Stromberg J, Turen CH, Bouaicha S. Acetabular fracture types vary with different acetabular version. Int Orthop. 2012;36(12):2559-63. doi: 10.1007/s00264-012-1687-2. [PubMed: 23104675]. [PubMed Central: PMC3508050].
12. Jeon JH, Park JH, Oh C, Chung JK, Song JY, Kim S, et al. Dementia is Associated with an Increased Risk of Hip Fractures: A Nationwide Analysis in Korea. J Clin Neurol. 2019;15(2):243-9. doi: 10.3988/jcn.2019.15.2.243. [PubMed: 30938111]. [PubMed Central: PMC6444145].
13. Wehren LE, Magaziner J. Hip fracture: risk factors and outcomes. Curr Osteoporos Rep. 2003;1(2):78-85. doi: 10.1007/s11914-003-0013-8. [PubMed: 16036069].
14. Frank CJ, Zacharias J, Garvin KL. Acetabular fractures. Nebr Med J. 1995;80(5):118-23. [PubMed: 7791944].
15. Gebre RK, Hirvasniemi J, Lantto I, Saarakkala S, Leppilahti J, Jämsä T. Structural risk factors for low-energy acetabular fractures. Bone. 2019;127:334-42. doi: 10.1016/j.bone.2019.07.004. [PubMed: 31283995].
16. Novais EN, Ferrer MG, Williams KA, Bixby SD. Acetabular Retroversion and Decreased Posterior Coverage Are Associated With Sports-related Posterior Hip Dislocation in Adolescents. Clin Orthop Relat Res. 2019;477(5):1101-8. doi: 10.1097/corr.0000000000000514. [PubMed: 30272610]. [PubMed Central: PMC6494309].
17. Kopydlowski NJ, Tannenbaum EP, Bedi A, Smith MV, Sekiya JK. An increase in cranial acetabular version with age: implications for femoroacetabular impingement. J Arthroplasty. 2014;29(9):1741-4. doi: 10.1016/j.arth.2014.03.042. [PubMed: 24851791].
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IssueVol 12 No 3 (2026) QRcode
SectionResearch Articles
Keywords
Acetabulum Bone Retroversion Hip Fractures Bone Hip
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How to Cite
1.
Mirmoosavi S, Soleimani M, Siavashi B, Fallah Y, Ashouri M, Shafiei SH, Golbakhsh M. The Association between Acetabular Fracture and Acetabular Retroversion: A Cross-Sectional Case-Control Study. J Orthop Spine Trauma. 2026;12(3):159-62.