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Although reduced coverage is the defining trait of DDH, more subtle and localized anatomic features of the joint are also thought to contribute to symptom development and degeneration. These features are challenging to identify using conventional approaches. Herein, we assessed the morphology of the full femur and hemi\u2010pelvis using an articulated statistical shape model (SSM). The model determined the morphological and pose\u2010based variations associated with DDH in a population of Japanese females and established which of these variations predict coverage. Computed tomography (CT) images of 83 hips from 47 patients were segmented for input into a correspondence\u2010based SSM. The dominant modes of variation in the model initially represented scale and pose. After removal of these factors through individual bone alignment, femoral version and neck\u2010shaft angle, pelvic curvature, and acetabular version dominated the observed variation. Femoral head oblateness and prominence of the acetabular rim and various muscle attachment sites of the femur and hemi\u2010pelvis were found to predict 3D CT\u2010based coverage measurements (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.5\u20130.7 for the full bones,<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.9 for the joint). Statement of Clinical Significance: Currently, clinical measurements of DDH only consider the morphology of the acetabulum. However, the results of this study demonstrated that variability in femoral head shape and several muscle attachment sites were predictive of femoral head coverage. These morphological differences may provide insight into improved clinical diagnosis and surgical planning based on functional adaptations of patients with DDH.<\/jats:p>","DOI":"10.1002\/jor.25227","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T11:35:31Z","timestamp":1637667331000},"page":"2113-2126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9930-2604","authenticated-orcid":false,"given":"Penny R.","family":"Atkins","sequence":"first","affiliation":[{"name":"Scientific Computing and Imaging Institute University of Utah Salt Lake City Utah USA"},{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-8281","authenticated-orcid":false,"given":"Praful","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Scientific Computing and Imaging Institute University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1609-1421","authenticated-orcid":false,"given":"Joseph D.","family":"Mozingo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-1743","authenticated-orcid":false,"given":"Keisuke","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Graduate School of Information Science Nara Institute of Science and Technology Ikoma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiko","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Niigata Hip Joint Center Kameda Daiichi Hospital Niigata Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7394-557X","authenticated-orcid":false,"given":"Shireen Y.","family":"Elhabian","sequence":"additional","affiliation":[{"name":"Scientific Computing and Imaging Institute University of Utah Salt Lake City Utah USA"},{"name":"School of Computing University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross T.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Scientific Computing and Imaging Institute University of Utah Salt Lake City Utah USA"},{"name":"School of Computing University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4708-2608","authenticated-orcid":false,"given":"Andrew E.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Scientific Computing and Imaging Institute University of Utah Salt Lake City Utah USA"},{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Department of Biomedical Engineering University of Utah Salt Lake City Utah USA"},{"name":"Department of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.58B2.932079"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jhps\/hnx041"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2015.08.008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2021.105335"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2014.6.2.127"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000153281.75265.1d"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5169-5"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2799-8"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2516-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","unstructured":"NeppleJJ WellsJ RossJR et al.2017. 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