A new study from Rady Children’s Hospital San Diego, published recently in The Journal of Bone & Joint Surgery, provides the most detailed 3D analysis to date of how the hip socket develops during adolescence.
The study was led by Vidyadhar Upasani, MD, director of Pediatric Orthopedics and Scoliosis Clinical Fellowship at Rady Children’s and professor of Clinical Orthopedic Surgery at UC San Diego School of Medicine, along with Matthew Schmitz, MD, director, International Center for Pediatric and Adolescent Hip Disorders at Rady Children’s and professor at UC San Diego School of Medicine.
The team used CT-based surface reconstructions of more than 500 normal hips (ages 8–19) to assess how secondary ossification centers affect acetabular morphology. Their findings show that:
- Os ilium ossification increases superior acetabular coverage.
- Os ischium ossification enhances posterior coverage.
- Os pubis ossification does not significantly change anterior coverage.
- Female patients showed greater anteversion and tilt, while males had larger surface area.
“Understanding these growth patterns helps us anticipate acetabular changes before pathology develops,” says Dr. Upasani. “It’s a step toward truly individualized treatment planning.”
The study reinforces the role of maturation of the secondary ossification centers of the acetabulum in achieving hip coverage/stability and provides new developmental benchmarks that may improve timing and precision of hip preservation surgery.
For surgeons, these findings provide a critical reference point for acetabular development during adolescence,” says Dr. Schmitz. “Knowing how each ossification center contributes to coverage allows us to refine surgical timing and technique, ensuring interventions are both necessary and optimally effective.”