A Quantitative Method to Assess Focal Acetabular Overcoverage Resulting From Pincer Deformity Using CT Data

  • Ryan J. Murphy
  • Ty K. Subhawong
  • Avneesh Chhabra
  • John A. Carrino
  • Mehran Armand
  • Marc Hungerford
Basic Research

Abstract

Background

Current assessment techniques for focal acetabular overcoverage are neither consistent nor quantitatively accurate.

Questions/purposes

We propose: (1) a method to precisely quantify the amount of focal acetabular overcoverage in a patient’s pincer deformity based on CT data; (2) to evaluate the consistency of this method; and (3) to compare the method with conventional radiographic assessments.

Methods

We developed a method to assess focal acetabular overcoverage using points selected from CT scans along the acetabular rim after realigning the pelvis into a neutral position. Using four resampled and segmented pelvic CT scans of cadaveric specimens with virtually induced impingement, two observers independently tested the algorithm’s consistency. Our algorithm assessed the amount of focal acetabular overcoverage using CT data and projected data from reconstructed radiographs.

Results

(1) We successfully showed the feasibility of the software to produce consistent, quantitative measurements. (2) Testing showed the average difference between observers in aligning the pelvis was 0.42°, indicative of a consistent approach. (3) Differences between measurements on three-dimensional (3-D) CT and simulated radiographs were significant.

Conclusions

The proposed method represents a new avenue in consistently quantifying focal acetabular overcoverage using CT models while correcting for pelvic tilt and rotation. Our analysis confirms AP hip radiograph simulations overestimate the amount of overhanging acetabular rim in a pincer deformity.

Clinical Relevance

This technique has potential to improve preoperative diagnostic accuracy and enhance surgical planning for correction of a pincer deformity resulting from focal acetabular overcoverage.

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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Ryan J. Murphy
    • 1
  • Ty K. Subhawong
    • 2
  • Avneesh Chhabra
    • 2
  • John A. Carrino
    • 2
    • 3
  • Mehran Armand
    • 1
    • 3
  • Marc Hungerford
    • 4
  1. 1.Milton S. Eisenhower Research CenterThe Johns Hopkins University Applied Physics LaboratoryLaurelUSA
  2. 2.The Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins HospitalBaltimoreUSA
  3. 3.The Department of Orthopaedic SurgeryThe Johns Hopkins HospitalBaltimoreUSA
  4. 4.The Department of Orthopaedic SurgeryMercy HospitalBaltimoreUSA

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