From the Guidelines
Os acetabulum is a rare anatomical variant that typically does not require treatment unless it causes symptoms, in which case conservative management with physical therapy is usually the first line of treatment, with surgical intervention reserved for persistent cases. The os acetabulum is a small accessory bone that can develop within the acetabular labrum of the hip joint, forming when a secondary ossification center fails to fuse with the main acetabular bone during development 1. This accessory bone is typically found at the posterior-superior aspect of the acetabulum and is often an incidental finding on imaging studies, usually asymptomatic. However, in some cases, it may contribute to hip pain or impingement if it becomes unstable or if it alters the normal biomechanics of the hip joint.
Some studies have reported on the management of chondral injuries of the hip, including osteochondral allograft transplantation (OAT) and microfracture, which may be relevant to the treatment of os acetabulum in certain cases 1. For example, OAT is another option for management of osteochondral defects of the hip, particularly for large lesions or those with substantial loss of subchondral bone, and has been shown to provide good clinical results in a few reported cases 1. Microfracture is also a simple and effective modality for management of full-thickness chondral lesions of the acetabulum, with studies reporting substantial improvement in symptoms and function in patients with small to medium-sized lesions 1.
The treatment algorithm for acetabular lesions, including os acetabulum, typically involves conservative management with physical therapy as the first line of treatment, with surgical intervention reserved for persistent cases or large lesions 1. The choice of surgical treatment depends on the size and location of the lesion, as well as the patient's age and overall health. In general, the goal of treatment is to relieve symptoms, improve function, and prevent further damage to the hip joint.
Key points to consider in the management of os acetabulum include:
- Conservative management with physical therapy is usually the first line of treatment
- Surgical intervention is reserved for persistent cases or large lesions
- OAT and microfracture are potential surgical options for management of osteochondral defects of the hip
- The treatment algorithm for acetabular lesions depends on the size and location of the lesion, as well as the patient's age and overall health.
From the Research
Os Acetabulum Overview
- The os acetabulum, also known as the acetabulum, is a part of the pelvis that forms the hip socket 2.
- Acetabular fractures can be treated surgically or conservatively, depending on the degree of displacement and other factors [(2,3)].
Treatment Options
- Surgical treatment is often recommended for displaced acetabular fractures, as it can provide better outcomes and reduce the risk of complications [(2,3)].
- Conservative treatment may be suitable for non-displaced or slightly displaced fractures, as well as for patients who are medically unfit for surgery [(2,4)].
- Intra-articular steroid injections and neuromotor training programs may also be used as part of a conservative management plan 5.
Outcomes and Rehabilitation
- The outcome of acetabular fracture treatment depends on various factors, including the degree of displacement, the quality of reduction, and the patient's overall health [(2,3)].
- Rehabilitation protocols play a crucial role in achieving good outcomes after both nonoperative and surgical treatment 6.
- Return to play after femoroacetabular impingement treatment is possible with a well-designed rehabilitation protocol, but more research is needed to establish a gold standard 6.
Specific Considerations
- In elderly patients, conservative management of acetabular fractures may be considered on a case-by-case basis, taking into account patient, injury, and surgical factors 4.
- A multidisciplinary approach focused on early mobility, minimization of risk, and regular follow-up can help optimize patient outcomes 4.