{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:38:57Z","timestamp":1792604337948,"version":"4.5.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Developmental dysplasia of the hip (DDH) alters joint mechanics and increases the risk of labral injury, compromising hip stability and leading to abnormal stress distribution and cartilage degeneration. However, the relationship between labral injury severity and joint loading stress in DDH remains unclear. This study investigated the effect of labral injury severity on stress distribution in DDH patients using computed tomography osteoabsorptometry (CT-OAM) and finite element analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We analyzed 54 hips from 45 female patients undergoing joint-preserving surgery for DDH. Labral injuries were classified as simple or complicated on radial MRI. Subchondral bone density distribution was evaluated with CT-OAM, while finite element analysis of pelvic and femoral bones with cartilage was performed under a single-leg stance to assess contact pressure and area. Statistical analyses examined associations between labral injury severity and stress distribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Superior injuries showed significantly increased high-density area (HDA) in the superior acetabulum, indicating localized stress concentration (simple injury vs. complicated injury, 64.4% vs. 80.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, finite element analysis revealed no significant differences in contact pressure or area (simple vs. complicated, 5.3\u00a0N\/mm\u00b2 vs. 6.2\u00a0N\/mm\u00b2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.538), which we interpret as showing that bony morphology alone could not explain the observed stress patterns. Instead, the discrepancy highlights the role of labral failure reflected in CT-derived subchondral bone density.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Complicated labral injuries, especially superiorly, were associated with localized stress accumulation in DDH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06452-8","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:51:20Z","timestamp":1792601480000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Complicated labral injuries in female patients with developmental dysplasia of the hip are associated with localized stress concentration in the superior acetabulum"],"prefix":"10.1007","volume":"146","author":[{"given":"Yuki","family":"Ogawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6760-3066","authenticated-orcid":false,"given":"Tomohiro","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ohashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Sugawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norimasa","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"6","key":"6452_CR1","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1016\/j.joca.2011.01.017","volume":"19","author":"K Akiyama","year":"2011","unstructured":"Akiyama K, Sakai T, Koyanagi J, Yoshikawa H, Sugamoto K (2011) Evaluation of translation in the normal and dysplastic hip using three-dimensional magnetic resonance imaging and voxel-based registration. Osteoarthritis Cartilage 19(6):700\u2013710","journal-title":"Osteoarthritis Cartilage"},{"issue":"9S1","key":"6452_CR2","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1016\/j.arth.2024.05.035","volume":"39","author":"PE Beaul\u00e9","year":"2024","unstructured":"Beaul\u00e9 PE, Verhaegen JCF, Clohisy JC et al (2024) The Otto Aufranc Award: Does Hip Arthroscopy at the Time of Periacetabular Osteotomy Improve the Clinical Outcome for the Treatment of Hip Dysplasia? A Multicenter Randomized Clinical Trial. J Arthroplasty 39(9S1):S9\u2013S16","journal-title":"J Arthroplasty"},{"issue":"8","key":"6452_CR3","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/j.jbiomech.2006.08.003","volume":"40","author":"M Bessho","year":"2007","unstructured":"Bessho M, Ohnishi I, Matsuyama J, Matsumoto T, Imai K, Nakamura K (2007) Prediction of strength and strain of the proximal femur by a CT-based finite element method. J Biomech 40(8):1745\u20131753","journal-title":"J Biomech"},{"issue":"9","key":"6452_CR4","doi-asserted-by":"publisher","first-page":"232596712211188","DOI":"10.1177\/23259671221118831","volume":"10","author":"B Capurro","year":"2022","unstructured":"Capurro B, Reina F, Carrera A et al (2022) Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics. Orthop J Sports Med 10(9):23259671221118831","journal-title":"Orthop J Sports Med"},{"issue":"8","key":"6452_CR5","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1302\/0301-620X.90B8.20161","volume":"90","author":"M Cashin","year":"2008","unstructured":"Cashin M, Uhthoff H, O\u2019Neill M, Beaul\u00e9 PE (2008) Embryology of the acetabular labral-chondral complex. J Bone Joint Surg Br 90(8):1019\u20131024","journal-title":"J Bone Joint Surg Br"},{"issue":"11","key":"6452_CR6","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1177\/0363546513499154","volume":"41","author":"BG Domb","year":"2013","unstructured":"Domb BG, Stake CE, Lindner D, El-Bitar Y, Jackson TJ (2013) Arthroscopic capsular plication and labral preservation in borderline hip dysplasia: two-year clinical outcomes of a surgical approach to a challenging problem. Am J Sports Med 41(11):2591\u20132598","journal-title":"Am J Sports Med"},{"issue":"6","key":"6452_CR7","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/j.arthro.2016.03.016","volume":"32","author":"MK Dwyer","year":"2016","unstructured":"Dwyer MK, Lewis CL, Hanmer AW, McCarthy JC (2016) Do Neuromuscular Alterations Exist for Patients With Acetabular Labral Tears During Function? Arthroscopy 32(6):1045\u20131052","journal-title":"Arthroscopy"},{"issue":"7","key":"6452_CR8","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.2106\/JBJS.G.00467","volume":"90","author":"CJ Dy","year":"2008","unstructured":"Dy CJ, Thompson MT, Crawford MJ, Alexander JW, McCarthy JC, Noble PC (2008) Tensile strain in the anterior part of the acetabular labrum during provocative maneuvering of the normal hip. J Bone Joint Surg Am 90(7):1464\u20131472","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"6452_CR9","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/BF01627879","volume":"15","author":"F Eckstein","year":"1993","unstructured":"Eckstein F, Putz R, M\u00fcller-Gerbl M, Steinlechner M, Benedetto KP (1993) Cartilage degeneration in the human patellae and its relationship to the mineralisation of the underlying bone: a key to the understanding of chondromalacia patellae and femoropatellar arthrosis? Surg Radiol Anat 15(4):279\u2013286","journal-title":"Surg Radiol Anat"},{"issue":"11","key":"6452_CR10","doi-asserted-by":"publisher","first-page":"232596712412724","DOI":"10.1177\/23259671241272493","volume":"12","author":"AT Fithian","year":"2024","unstructured":"Fithian AT, Storaci HW, Chan CK, Finlay AK, Safran MR (2024) Effect of Acetabular Labral Tear Orientation on Hip Joint Kinematics: A Comparison of Radial Tears, Chondrolabral Junction Tears and Complex Tears in Cadaveric Hips. Orthop J Sports Med 12(11):23259671241272493","journal-title":"Orthop J Sports Med"},{"issue":"5","key":"6452_CR11","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1177\/03635465231156189","volume":"51","author":"AJD Flemig","year":"2023","unstructured":"Flemig AJD, Selley RS, Essilfie A et al (2023) The Effects of Arthroscopic Labral Repair on Patient-Reported Outcomes in the Setting of Periacetabular Osteotomy. Am J Sports Med 51(5):1217\u20131223","journal-title":"Am J Sports Med"},{"issue":"1","key":"6452_CR12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/BPO.0b013e318190a0be","volume":"29","author":"M Fujii","year":"2009","unstructured":"Fujii M, Nakashima Y, Jingushi S et al (2009) Intraarticular findings in symptomatic developmental dysplasia of the hip. J Pediatr Orthop 29(1):9\u201313","journal-title":"J Pediatr Orthop"},{"issue":"10","key":"6452_CR13","doi-asserted-by":"publisher","first-page":"232596712412756","DOI":"10.1177\/23259671241275661","volume":"12","author":"G Gao","year":"2024","unstructured":"Gao G, Zhou C, Zhou G et al (2024) Clinical Outcomes of the Arthroscopic Capsular Suture-Lifting Technique in the Treatment of Femoroacetabular Impingement in Patients With Borderline Developmental Dysplasia of the Hip. Orthop J Sports Med 12(10):23259671241275661","journal-title":"Orthop J Sports Med"},{"issue":"1","key":"6452_CR14","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/0363546517730583","volume":"46","author":"A Hatakeyama","year":"2018","unstructured":"Hatakeyama A, Utsunomiya H, Nishikino S et al (2018) Predictors of Poor Clinical Outcome After Arthroscopic Labral Preservation, Capsular Plication, and Cam Osteoplasty in the Setting of Borderline Hip Dysplasia. Am J Sports Med 46(1):135\u2013143","journal-title":"Am J Sports Med"},{"issue":"12","key":"6452_CR15","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.1016\/j.jbiomech.2011.06.011","volume":"44","author":"CR Henak","year":"2011","unstructured":"Henak CR, Ellis BJ, Harris MD, Anderson AE, Peters CL, Weiss JA (2011) Role of the acetabular labrum in load support across the hip joint. J Biomech 44(12):2201\u20132206","journal-title":"J Biomech"},{"issue":"4","key":"6452_CR16","doi-asserted-by":"publisher","first-page":"767","DOI":"10.2106\/00004623-195032040-00004","volume":"32 A","author":"CH Heyman","year":"1950","unstructured":"Heyman CH, Herndon CH (1950) Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg Am 32 A(4):767\u2013778","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"6452_CR17","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1302\/0301-620X.97B4.33736","volume":"97\u2013B","author":"H Ike","year":"2015","unstructured":"Ike H, Inaba Y, Kobayashi N et al (2015) Effects of rotational acetabular osteotomy on the mechanical stress within the hip joint in patients with developmental dysplasia of the hip: a subject-specific finite element analysis. Bone Joint J 97\u2013B(4):492\u2013497","journal-title":"Bone Joint J"},{"issue":"5","key":"6452_CR18","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1053\/jhsu.2000.16353","volume":"25","author":"N Iwasaki","year":"2000","unstructured":"Iwasaki N, Minami A, Miyazawa T, Kaneda K (2000) Force distribution through the wrist joint in patients with different stages of Kienb\u00f6ck\u2019s disease: using computed tomography osteoabsorptiometry. J Hand Surg Am 25(5):870\u2013876","journal-title":"J Hand Surg Am"},{"issue":"1","key":"6452_CR19","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1007\/s11999-010-1316-6","volume":"469","author":"MU Jawad","year":"2011","unstructured":"Jawad MU, Scully SP (2011) In brief: Crowe\u2019s classification: arthroplasty in developmental dysplasia of the hip. Clin Orthop Relat Res 469(1):306\u2013308","journal-title":"Clin Orthop Relat Res"},{"issue":"9","key":"6452_CR20","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1016\/j.arthro.2022.02.017","volume":"38","author":"AE Jimenez","year":"2022","unstructured":"Jimenez AE, Lee MS, Owens JS, Maldonado DR, LaReau JM, Domb BG (2022) Athletes Undergoing Concomitant Hip Arthroscopy and Periacetabular Osteotomy Demonstrate Greater Than 80% Return-to-Sport Rate at 2-Year Minimum Follow-Up. Arthroscopy 38(9):2649\u20132658","journal-title":"Arthroscopy"},{"issue":"2","key":"6452_CR21","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/S0021-9290(97)00123-1","volume":"31","author":"JH Keyak","year":"1998","unstructured":"Keyak JH, Rossi SA, Jones KA, Skinner HB (1998) Prediction of femoral fracture load using automated finite element modeling. J Biomech 31(2):125\u2013133","journal-title":"J Biomech"},{"issue":"8","key":"6452_CR22","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.1097\/CORR.0000000000001737","volume":"479","author":"K Kitamura","year":"2021","unstructured":"Kitamura K, Fujii M, Ikemura S, Hamai S, Motomura G, Nakashima Y (2021) Does Patient-specific Functional Pelvic Tilt Affect Joint Contact Pressure in Hip Dysplasia? A Finite-element Analysis Study. Clin Orthop Relat Res 479(8):1712\u20131724","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"6452_CR23","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/CORR.0000000000001893","volume":"480","author":"K Kitamura","year":"2022","unstructured":"Kitamura K, Fujii M, Iwamoto M et al (2022) Is Anterior Rotation of the Acetabulum Necessary to Normalize Joint Contact Pressure in Periacetabular Osteotomy? A Finite-element Analysis Study. Clin Orthop Relat Res 480(1):67\u201378","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"6452_CR24","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1097\/01.blo.0000534679.75870.5f","volume":"476","author":"B Kovalenko","year":"2018","unstructured":"Kovalenko B, Bremjit P, Fernando N (2018) Classifications in Brief: T\u00f6nnis Classification of Hip Osteoarthritis. Clin Orthop Relat Res 476(8):1680\u20131684","journal-title":"Clin Orthop Relat Res"},{"key":"6452_CR25","first-page":"643","volume":"28","author":"MdSS Lequesne","year":"1961","unstructured":"Lequesne MdSS (1961) Le faux profil du bassin: Nouvelle incidence radiographique pour l\u2019\u00e9tude de la hanche. Son utilit\u00e9 dans les dysplasies et les diff\u00e9rentes coxopathies. Rev Rhum 28:643\u2013652","journal-title":"Rev Rhum"},{"key":"6452_CR26","doi-asserted-by":"crossref","unstructured":"Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R (2004) Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res (418):74\u201380","DOI":"10.1097\/00003086-200401000-00013"},{"issue":"1","key":"6452_CR27","doi-asserted-by":"publisher","first-page":"e0146452","DOI":"10.1371\/journal.pone.0146452","volume":"11","author":"L Liu","year":"2016","unstructured":"Liu L, Ecker TM, Schumann S, Siebenrock KA, Zheng G (2016) Evaluation of Constant Thickness Cartilage Models vs. Patient Specific Cartilage Models for an Optimized Computer-Assisted Planning of Periacetabular Osteotomy. PLoS ONE 11(1):e0146452","journal-title":"PLoS ONE"},{"issue":"3","key":"6452_CR28","doi-asserted-by":"publisher","first-page":"519","DOI":"10.2106\/00004623-195032030-00005","volume":"32\u2013A","author":"WK Massie","year":"1950","unstructured":"Massie WK, Howorth MB (1950) Congenital dislocation of the hip. Part I. Method of grading results. J Bone Joint Surg Am 32\u2013A(3):519\u2013531","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"6452_CR29","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s00776-011-0166-8","volume":"17","author":"T Matsumoto","year":"2012","unstructured":"Matsumoto T, Kaneuji A, Hiejima Y et al (2012) Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association. J Orthop Sci 17(1):25\u201338","journal-title":"J Orthop Sci"},{"key":"6452_CR30","doi-asserted-by":"crossref","unstructured":"McCarthy JC, Lee JA (2002) Acetabular dysplasia: a paradigm of arthroscopic examination of chondral injuries. Clin Orthop Relat Res (405):122\u2013128","DOI":"10.1097\/00003086-200212000-00014"},{"issue":"7","key":"6452_CR31","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/BF00351749","volume":"18","author":"M M\u00fcller-Gerbl","year":"1989","unstructured":"M\u00fcller-Gerbl M, Putz R, Hodapp N, Schulte E, Wimmer B (1989) Computed tomography-osteoabsorptiometry for assessing the density distribution of subchondral bone as a measure of long-term mechanical adaptation in individual joints. Skeletal Radiol 18(7):507\u2013512","journal-title":"Skeletal Radiol"},{"issue":"2","key":"6452_CR32","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1055\/s-2008-1039487","volume":"128","author":"M M\u00fcller-Gerbl","year":"1990","unstructured":"M\u00fcller-Gerbl M, Putz R, Hodapp N, Schulte E, Wimmer B (1990) [Demonstration of subchondral density pattern using CT-osteoabsorptiometry (CT-OAM) for the assessment of individual joint stress in live patients]. Z Orthop Ihre Grenzgeb 128(2):128\u2013133","journal-title":"Z Orthop Ihre Grenzgeb"},{"issue":"8","key":"6452_CR33","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1016\/j.joca.2004.04.009","volume":"12","author":"T Nishii","year":"2004","unstructured":"Nishii T, Sugano N, Sato Y, Tanaka H, Miki H, Yoshikawa H (2004) Three-dimensional distribution of acetabular cartilage thickness in patients with hip dysplasia: a fully automated computational analysis of MR imaging. Osteoarthritis Cartilage 12(8):650\u2013657","journal-title":"Osteoarthritis Cartilage"},{"issue":"5","key":"6452_CR34","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1053\/ar.1999.v15.015049","volume":"15","author":"Y Noguchi","year":"1999","unstructured":"Noguchi Y, Miura H, Takasugi S, Iwamoto Y (1999) Cartilage and labrum degeneration in the dysplastic hip generally originates in the anterosuperior weight-bearing area: an arthroscopic observation. Arthroscopy 15(5):496\u2013506","journal-title":"Arthroscopy"},{"issue":"1","key":"6452_CR35","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1302\/0301-620X.84B1.0840059","volume":"84","author":"M Nozawa","year":"2002","unstructured":"Nozawa M, Shitoto K, Matsuda K, Maezawa K, Kurosawa H (2002) Rotational acetabular osteotomy for acetabular dysplasia. A follow-up for more than ten years. J Bone Joint Surg Br 84(1):59\u201365","journal-title":"J Bone Joint Surg Br"},{"key":"6452_CR36","unstructured":"Pauwels F (2012) Biomechanics of the locomotor apparatus: contributions on the functional anatomy of the locomotor apparatus. Springer Science & Business Media"},{"issue":"Suppl","key":"6452_CR37","doi-asserted-by":"publisher","first-page":"72S","DOI":"10.1177\/0363546511412320","volume":"39","author":"JR Ross","year":"2011","unstructured":"Ross JR, Zaltz I, Nepple JJ, Schoenecker PL, Clohisy JC (2011) Arthroscopic disease classification and interventions as an adjunct in the treatment of acetabular dysplasia. Am J Sports Med 39(Suppl):72S\u201378S","journal-title":"Am J Sports Med"},{"issue":"Suppl","key":"6452_CR38","doi-asserted-by":"publisher","first-page":"92S","DOI":"10.1177\/0363546511414017","volume":"39","author":"MR Safran","year":"2011","unstructured":"Safran MR, Giordano G, Lindsey DP et al (2011) Strains across the acetabular labrum during hip motion: a cadaveric model. Am J Sports Med 39(Suppl):92S\u2013102S","journal-title":"Am J Sports Med"},{"issue":"4","key":"6452_CR39","doi-asserted-by":"publisher","first-page":"103539","DOI":"10.1016\/j.otsr.2022.103539","volume":"109","author":"T Savoye-Laurens","year":"2023","unstructured":"Savoye-Laurens T, Verdier N, Wettstein M, Baulot E, Gedouin JE, Martz P (2023) Labral tears in hip dysplasia and femoroacetabular impingement: A systematic review. Orthop Traumatol Surg Res 109(4):103539","journal-title":"Orthop Traumatol Surg Res"},{"issue":"3","key":"6452_CR40","doi-asserted-by":"publisher","first-page":"91","DOI":"10.5435\/JAAOS-D-18-00533","volume":"28","author":"MR Schmitz","year":"2020","unstructured":"Schmitz MR, Murtha AS, Clohisy JC, Group AS (2020) Developmental Dysplasia of the Hip in Adolescents and Young Adults. J Am Acad Orthop Surg 28(3):91\u2013101","journal-title":"J Am Acad Orthop Surg"},{"issue":"11","key":"6452_CR41","doi-asserted-by":"publisher","first-page":"2626","DOI":"10.1002\/jor.25284","volume":"40","author":"T Shimizu","year":"2022","unstructured":"Shimizu T, Takahashi D, Nakamura Y et al (2022) Effect of periacetabular osteotomy on the distribution pattern of subchondral bone mineral density in patients with hip dysplasia. J Orthop Res 40(11):2626\u20132631","journal-title":"J Orthop Res"},{"key":"6452_CR42","doi-asserted-by":"publisher","first-page":"687419","DOI":"10.3389\/fspor.2021.687419","volume":"3","author":"K Song","year":"2021","unstructured":"Song K, Pascual-Garrido C, Clohisy JC, Harris MD (2021) Acetabular Edge Loading During Gait Is Elevated by the Anatomical Deformities of Hip Dysplasia. Front Sports Act Living 3:687419","journal-title":"Front Sports Act Living"},{"issue":"1","key":"6452_CR43","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1093\/jhps\/hnz004","volume":"6","author":"AV Stone","year":"2019","unstructured":"Stone AV, Mehta N, Beck EC et al (2019) Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome. J Hip Preserv Surg 6(1):33\u201340","journal-title":"J Hip Preserv Surg"},{"issue":"1","key":"6452_CR44","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1177\/0363546515604667","volume":"44","author":"S Uchida","year":"2016","unstructured":"Uchida S, Utsunomiya H, Mori T et al (2016) Clinical and Radiographic Predictors for Worsened Clinical Outcomes After Hip Arthroscopic Labral Preservation and Capsular Closure in Developmental Dysplasia of the Hip. Am J Sports Med 44(1):28\u201338","journal-title":"Am J Sports Med"},{"issue":"3","key":"6452_CR45","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1002\/jor.22245","volume":"31","author":"Z Zou","year":"2013","unstructured":"Zou Z, Ch\u00e1vez-Arreola A, Mandal P, Board TN, Alonso-Rasgado T (2013) Optimization of the position of the acetabulum in a ganz periacetabular osteotomy by finite element analysis. J Orthop Res 31(3):472\u2013479","journal-title":"J Orthop Res"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06452-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-026-06452-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-026-06452-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:51:22Z","timestamp":1792601482000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-026-06452-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6452"],"URL":"https:\/\/doi.org\/10.1007\/s00402-026-06452-8","relation":{},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"assertion":[{"value":"20 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"377"}}