Skip to main content
SpringerLink
Log in

Analysis of acetabular orientation and femoral anteversion using images of three-dimensional reconstructed bone models

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Radiographic measurements using two-dimensional (2D) plain radiographs or planes from computed tomography (CT) scans have several drawbacks, while measurements using images of three-dimensional (3D) reconstructed bone models can provide more consistent anthropometric information. We compared the consistency of results using measurements based on images of 3D reconstructed bone models (3D measurements) with those using planes from CT scans (measurements using 2D slice images).

Methods

Ninety-six of 561 patients who had undergone deep vein thrombosis-CT between January 2013 and November 2014 were randomly selected. We evaluated measurements using 2D slice images and 3D measurements. The images used for 3D reconstruction of bone models were obtained and measured using \(\hbox {Mimics}^{\mathrm{\textregistered }}\) and \(\hbox {3-Matics}^{\mathrm{\textregistered }}\) (Materialize, Leuven, Belgium).

Results

The mean acetabular inclination, acetabular anteversion and femoral anteversion values on 2D slice images were 42.01\(^{\circ }\), 18.64\(^{\circ }\) and 14.44\(^{\circ }\), respectively, while those using images of 3D reconstructed bone models were 52.80\(^{\circ }\), 14.98\(^{\circ }\) and 17.26\(^{\circ }\). Intra-rater reliabilities for acetabular inclination, acetabular anteversion, and femoral anteversion on 2D slice images were 0.55, 0.81, and 0.85, respectively, while those for 3D measurements were 0.98, 0.99, and 0.98. Inter-rater reliabilities for acetabular inclination, acetabular anteversion and femoral anteversion on 2D slice images were 0.48, 0.86, and 0.84, respectively, while those for 3D measurements were 0.97, 0.99, and 0.97.

Conclusion

The differences between the two measurements are explained by the use of different tools. However, more consistent measurements were possible using the images of 3D reconstructed bone models. Therefore, 3D measurement can be a good alternative to measurement using 2D slice images.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Tsai TY, Dimitriou D, Li G, Kwon YM (2014) Does total hip arthroplasty restore native hip anatomy? Three-dimensional reconstruction analysis. Int Orthop 38(8):1577–1583

    Article  PubMed  PubMed Central  Google Scholar 

  2. Zhang J, Wang L, Mao Y, Li H, Ding H, Zhu Z (2014) The use of combined anteversion in total hip arthroplasty for patients with developmental dysplasia of the hip. J Arthroplasty 29(3):621–625

    Article  PubMed  Google Scholar 

  3. Hayashi S, Nishiyama T, Fujishiro T, Hashimoto S, Kanzaki N, Nishida K, Kuroda R, Kurosaka M (2013) Evaluation of the accuracy of femoral component orientation by the CT-based fluoro-matched navigation system. Int Orthop 37(6):1063–1068

    Article  PubMed  PubMed Central  Google Scholar 

  4. Babisch JW, Layher F, Amiot L-P (2008) The rationale for tilt-adjusted acetabular cup navigation. J Bone Joint Surg Am 90(2):357–365

    Article  PubMed  Google Scholar 

  5. Grammatopoulos G, Pandit H, Da Assunção R, McLardy-Smith P, De Smet K, Gill H, Murray D (2014) The relationship between operative and radiographic acetabular component orientation which factors influence resultant cup orientation? Bone Joint J 96(10):1290–1297

    Article  PubMed  Google Scholar 

  6. Lu M, Zhou Y-X, Du H, Zhang J, Liu J (2013) Reliability and validity of measuring acetabular component orientation by plain anteroposterior radiographs. Clin Orthop Relat Res 471(9):2987–2994

    Article  PubMed  PubMed Central  Google Scholar 

  7. Eilander W, Harris S, Henkus H, Cobb J, Hogervorst T (2013) Functional acetabular component position with supine total hip replacement. Bone Joint J 95(10):1326–1331

    Article  PubMed  Google Scholar 

  8. Derbyshire B, Diggle PJ, Ingham CJ, Macnair R, Wimhurst J, Jones HW (2014) A new technique for radiographic measurement of acetabular cup orientation. J Arthroplasty 29(2):369–372

    Article  PubMed  Google Scholar 

  9. Parratte S, Kilian P, Pauly V, Champsaur P, Argenson J-N (2008) The use of ultrasound in acquisition of the anterior pelvic plane in computer-assisted total hip replacement: a CADAVER study. J Bone Joint Surg Br 90(2):258–263

    Article  CAS  PubMed  Google Scholar 

  10. Loftus M, Ma Y, Ghelman B (2015) Acetabular version measurement in total hip arthroplasty: the impact of inclination and the value of multi-planar CT reformation. HSS J 11(1):65–70

    Article  PubMed  PubMed Central  Google Scholar 

  11. Shin W, Lee S, Lee K, Cho H, Lee J, Suh K (2015) The reliability and accuracy of measuring anteversion of the acetabular component on plain anteroposterior and lateral radiographs after total hip arthroplasty. Bone Joint J 97(5):611–616

    Article  PubMed  Google Scholar 

  12. Craiovan B, Weber M, Worlicek M, Schneider M, Springorum H, Zeman F, Grifka J, Renkawitz T (2016) Measuring acetabular cup orientation on antero–posterior radiographs of the hip after total hip arthroplasty with a vector arithmetic radiological method. Is it valid and verified for daily Clinical practice? In: RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. Georg Thieme Verlag KG, pp 574–581

  13. Marx A, von Knoch M, Pförtner J, Wiese M, Saxler G (2006) Misinterpretation of cup anteversion in total hip arthroplasty using planar radiography. Arch Orthop Trauma Surg 126(7):487–492

    Article  PubMed  Google Scholar 

  14. Lewinnek GE, Lewis J, Tarr R, Compere C, Zimmerman J (1978) Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 60(2):217–220

    Article  CAS  PubMed  Google Scholar 

  15. Wassilew GI, Perka C, Koenig C, Janz V, Asbach P, Hasart O (2010) 3D CT analysis of combined cup and stem anteversion in cases of cup navigation in hip arthroplasty. Orthopedics 33(10 Suppl):48–51

    Article  PubMed  Google Scholar 

  16. Merle C, Grammatopoulos G, Waldstein W, Pegg E, Pandit H, Aldinger PR, Gill HS, Murray DW (2013) Comparison of native anatomy with recommended safe component orientation in total hip arthroplasty for primary osteoarthritis. J Bone Joint Surg Am 95(22):e172

    Article  PubMed  Google Scholar 

  17. Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW (2016) What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Orthop Relat Res 474(2):386–391

    Article  PubMed  Google Scholar 

  18. Wan Z, Malik A, Jaramaz B, Chao L, Dorr LD (2009) Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res 467(1):32–42

    Article  PubMed  Google Scholar 

  19. Yun HH, Yoon JR, Yang J-H, Song SY, Park SB, Lee JW (2013) A validation study for estimation of femoral anteversion using the posterior lesser trochanter line: an analysis of computed tomography measurement. J Arthroplasty 28(10):1776–1780

    Article  PubMed  Google Scholar 

  20. Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT (1987) Femoral anteversion. J Bone Joint Surg Am 69(8):1169–1176

  21. Park KK, Tsai T-Y, Dimitriou D, Kwon Y-M (2015) Utility of preoperative femoral neck geometry in predicting femoral stem anteversion. J Arthroplasty 30(6):1079–1084

    Article  PubMed  Google Scholar 

  22. Zeng Y, Wang Y, Zhu Z, Tang T, Dai K, Qiu S (2012) Differences in acetabular morphology related to side and sex in a Chinese population. J Anat 220(3):256–262

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jiang N, Peng L, Al-Qwbani M, Xie G-P, Yang Q-M, Chai Y, Zhang Q, Yu B (2015) Femoral version, neck-shaft angle, and acetabular anteversion in Chinese Han population: a retrospective analysis of 466 healthy adults. Medicine 94(21):e891

  24. Tannenbaum E, Kopydlowski N, Smith M, Bedi A, Sekiya JK (2014) Gender and racial differences in focal and global acetabular version. J Arthroplasty 29(2):373–376

    Article  PubMed  Google Scholar 

  25. Koerner JD, Patel NM, Yoon RS, Sirkin MS, Reilly MC, Liporace FA (2013) Femoral version of the general population: does “normal” vary by gender or ethnicity? J Orthop Trauma 27(6):308–311

    Article  PubMed  Google Scholar 

  26. Tannenbaum EP, Zhang P, Maratt JD, Gombera MM, Holcombe SA, Wang SC, Bedi A, Goulet JA (2015) A computed tomography study of gender differences in acetabular version and morphology: implications for femoroacetabular impingement. Arthrosc J Arthrosc Relat Surg 31(7):1247–1254

    Article  Google Scholar 

  27. Jozwiak M, Rychlik M, Musielak B, Chen BP, Idzior M, Grzegorzewski A (2015) An accurate method of radiological assessment of acetabular volume and orientation in computed tomography spatial reconstruction. BMC Musculoskelet Disord 16:42

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hohne KH, Bernstein R (1986) Shading 3D-images from CT using gray-level gradients. IEEE Trans Med Imaging 5(1):45–47

    Article  CAS  PubMed  Google Scholar 

  29. Abbena E, Salamon S, Gray A (2006) Modern differential geometry of curves and surfaces with Mathematica. CRC Press, Boca Raton

    Google Scholar 

  30. Bland JM, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327(8476):307–310

    Article  Google Scholar 

  31. Murray D (1993) The definition and measurement of acetabular orientation. J Bone Joint Surg Br 75(2):228–232

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by the following programs: (1) “Establishment program of Industrial infrastructure for custom body treatment” through the Ministry of Trade-Industry-Energy and Korea Institute for Advancement of Technology (Grant No. A011800027) and (2) “Development of ICT-based software platform and service technologies for medical 3D printing applications” through the ICT R&D program of the Information and Communications Technology Promotion/Ministry of Science, ICT and Future Planning (Grant No. B0101-15-1081).

Authors contribution Each author took part in the design of the study and contributed to acquisition of data, analysis, and interpretation of data and agreed to accept equal responsibility for the accuracy of the content of the paper. All authors participated in drafting the article or revising it critically for important intellectual content and gave final approval of the version to be submitted and any revised version.

Author information

Authors and Affiliations

  1. Division of Biomedical Science, Kyungpook National University, Daegu, Republic of Korea

    Jaeyeong Park

  2. Department of Orthopedic Surgery, Kyungpook National University Hospital, 130 Dongeok-ro, Jung-gu, Daegu, 41944, Republic of Korea

    Jun-Young Kim, Il Hyung Park & Shin-Yoon Kim

  3. Institute of Advanced Convergence Technology, Kyungpook National University, Daegu, Republic of Korea

    Hyun Deok Kim, Young Cheol Kim & Anna Seo

  4. School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea

    Minkyu Je

  5. Department of Orthopedic Surgery, Changwon Gyeongsang National University Hospital, Changwon, Republic of Korea

    Jong Uk Mun

  6. Department of Psychology, Pusan National University, Pusan, Republic of Korea

    Bia Kim

Authors
  1. Jaeyeong Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun-Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyun Deok Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Cheol Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anna Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Minkyu Je
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jong Uk Mun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bia Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Il Hyung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shin-Yoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jun-Young Kim.

Ethics declarations

Conflict of interest

Author Young Cheol Kim has received research grants from the Ministry of Trade-Industry-Energy and Korea Institute for Advancement of Technology. Author Hyun Deok Kim has received research grants from the Institute for Information & Communications Technology Promotion and the Ministry of Science, ICT and Future Planning.

Ethical approval

This study was approved by the Institutional Review Board, and all procedures in this study were in accordance with ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (pptx 38049 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, J., Kim, JY., Kim, H.D. et al. Analysis of acetabular orientation and femoral anteversion using images of three-dimensional reconstructed bone models. Int J CARS 12, 855–864 (2017). https://doi.org/10.1007/s11548-016-1514-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-016-1514-0

Keywords

Search

Navigation