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Analysis of four methods of measuring three-dimensional pelvic tilt in the lateral decubitus position

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Abstract

Proper alignment of acetabular implantation is necessary for good patient outcomes and preventing complications or additional surgeries in total hip arthroplasty (THA). Rotation of the pelvis in lateral decubitus (LD) is typically not accounted for as surgeons use the surgery table as a reference plane to align implants. This study compared four techniques to measure 3D pelvic rotations in LD position using computer models. CT scans of 19 subjects in LD position were used to create 3D pelvis models. Pelvic rotations were measured by three users using four techniques: landmark (LM), defined plane (DP), anterior pelvic plane (APP), and plane of best symmetry (POBS) methods. Measurements were analysed for intra-user reliability and relationships between methods were assessed using intraclass correlation coefficient, standard error of measurement, and coefficient of determination. The POBS method exhibited the highest inter-observer reliability and is recommended as a new measurement technique to measure pelvic rotations before THA surgery. The LM method exhibited low reliability but may be suitable for expert users familiar with pelvic landmarks. The APP method should only be used when the patients’ APP planes are known in neutral standing and side-lying postures. The DP method is not recommended due to substantial individual variability.

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Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, University of Alberta, Edmonton, Canada

    Meredith Stadnyk

  2. Department of Mechanical Engineering, University of Alberta, Edmonton, Canada

    Tao Liu & Lindsey Westover

  3. Healthcare Engineering Innovation Center, Department of Mechanical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates

    Tao Liu & Marwan El-Rich

  4. Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Canada

    Fatemeh Fallahi Arezodar

  5. Department of Orthopaedics, University of Miami, Miami, USA

    Jaime A. Carvajal Alba

  6. Department of Surgery, University of Alberta, Edmonton, Canada

    Edward Masson

  7. Department of Physical Therapy, University of Alberta, Edmonton, Canada

    Lauren Beaupre

  8. Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada

    Jacob L. Jaremko

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  1. Meredith Stadnyk
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Correspondence to Marwan El-Rich.

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The authors declare that they have no conflict of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Alberta Health Research Ethics Board Health Panel (Pro00053235 and Pro00089030) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

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

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Stadnyk, M., Liu, T., Arezodar, F.F. et al. Analysis of four methods of measuring three-dimensional pelvic tilt in the lateral decubitus position. Med Biol Eng Comput 58, 2387–2396 (2020). https://doi.org/10.1007/s11517-020-02235-4

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  • DOI: https://doi.org/10.1007/s11517-020-02235-4

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