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The pelvis was oriented to the functional pelvic plane, and the cup was positioned at 20\u00b0 anteversion and 40\u00b0 inclination. The simulated reamed area was quantified at 12 clock-face positions. Simulated reamed areas were compared by diagnosis using Holm-adjusted Student\u2019s t tests and among positions using repeated-measures ANOVA with Holm adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean simulated reamed area was smallest at 1 o\u2019clock (64\u2009\u00b1\u200945 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) and largest at 8 o\u2019clock (137\u2009\u00b1\u200973 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Post hoc comparisons showed larger reamed areas at 8 and 9 o\u2019clock and smaller areas from 0 to 2 o\u2019clock than at most other positions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). This posteriorly concentrated pattern was particularly evident in mild DDH, with smaller reamed areas from 0 to 2 o\u2019clock and larger areas at 8 and 9 o\u2019clock than at other positions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this CT-based simulation study, simulated acetabular reaming was minimal in the anterosuperior region and greater posteriorly. These findings may provide anatomical information for understanding direction-specific reaming patterns, particularly in mild DDH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-06901-4","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:08:22Z","timestamp":1782281302000},"page":"2103-2111","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Where is acetabular reaming concentrated during total hip arthroplasty for hip osteoarthritis? 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