An In Vivo Radiologic Description of Periacetabular Vascularization in a Healthy Subject and a Literature Review of its Clinical Implications

Document Type : TECHNICAL NOTE


University of Turin Department of Orthopaedic and Traumatology, Italy



The aim of this study is to provide a radiologic description of periacetabular vascularization. A computed 
tomography angiography was used to analyze the vascularization patterns of the periacetabular region, 
describing for the first time “in vivo” the periacetabular branches of the superior and inferior gluteal 
artery, obturator artery, and of the medial circumflex femoral artery. The analysis revealed the 
possibility of visualizing clearly all the previously described vessels of the aforementioned arterie s. 
Both acetabular and supra-acetabular arteries, the rami of the OA directed to the lamina quadrilateral, 
and the rami of the IGA directed to the posterior wall were identified. In conclusion, understanding the 
periacetabular vascularization patterns is pivotal for effective clinical decision-making in pelvic trauma, 
and conservative and reconstructive surgery of the hip. The radiologic description provided in this study, 
along with the associated literature review, offers valuable insights into the clinic al implications of 
periacetabular vascularization.
 Level of evidence: V


Main Subjects

1. Damsin JP, Lazennec JY, Gonzales M, Guérin-Surville H, 
Hannoun L. Arterial supply of the acetabulum in the fetus: 
application to periacetabular surgery in childhood. Surg 
Radiol Anat. 1992; 14(3):215-221. doi:10.1007/BF01794942. 
doi: 10.1007/BF01794942.
2. Fischer LP, Noyer D, GP G, JP C, Morin A, Clermon A. [Arterial 
vascularization of the os coxae] Bull Assoc Anat (Nancy). 
1977; 61(174):343-356.
3. Seeley MA, Georgiadis AG, Sankar WN. Hip Vascularity: A 
Review of the Anatomy and Clinical Implications. J Am Acad 
Orthop Surg. 2016; 24(8):515-526. doi:10.5435/JAAOS-D-15-
00237. doi: 10.5435/JAAOS-D-15-00237.
4. Beck M, Leunig M, Ellis T, Sledge JB, Ganz R. The acetabular 
blood supply: implications for periacetabular osteotomies. 
Surg Radiol Anat. 2003; 25(5-6):361-367. 
5. Yiming A, Baqué P, Rahili A, et al. Anatomical study of the 
blood supply of the coxal bone: radiological and clinical 
application. Surg Radiol Anat. 2002; 24(2):81-86. 
6. Kalhor M, Beck M, Huff TW, Ganz R. Capsular and 
pericapsular contributions to acetabular and femoral head 
perfusion. J Bone Joint Surg Am. 2009; 91(2):409-418. 
7. Kalhor M, Horowitz K, Beck M, Nazparvar B, Ganz R. Vascular 
supply to the acetabular labrum. J Bone Joint Surg Am. 2010; 
92(15):2570-2575. doi:10.2106/JBJS.I.01719.
8. Itokazu M, Takahashi K, Matsunaga T, et al. A study of the 
arterial supply of the human acetabulum using a corrosion 
casting method. Clin Anat. 1997; 10(2):77-81. 
9. Vaidya R, Waldron J, Scott A, Nasr K. Angiography and 
Embolization in the Management of Bleeding Pelvic 
Fractures. J Am Acad Orthop Surg. 2018; 26(4):e68-e76. 
10. Matsumoto T. Bone graft for the acetabular bone cyst in 
rotational acetabular osteotomy. Hip Joint. 1991; 17:213-6.