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Assessment of cup position from plain radiographs: impact of pelvic tilting

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Abstract

The acetabular cup position after total hip arthroplasty (THA) regarding its inclination and version angles are influential parameters concerning the postoperative range of motion and dislocation stability. Standard anterior-posterior X-rays remain an important diagnostic instrument to observe the postoperative outcome and to secure quality control after THA, where an optimal positioning of the patient is recommended when taking these X-rays. The purpose of this preliminary study was to determine the effect of pelvic tilting regarding the positioning calculation of the acetabular cup from standard radiographs using a modified method according to Pettersson et al. (Acta Radiol Diagn, 23:259–263, 1982). In our model experiment, we were able to show that pelvic tilting to either side causes a considerable difference between the radiographic and calculated version angles following approximately linear functions. However, pelvic tilting to either side, leads, regarding the calculation of the inclination, to an average deviation between radiographic and calculated inclination angles less than 2°.

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Notes

  1. D1 und d1 are equivalent, respectively, to the long and the short diameter of the ellipse of the acetabular cup with a symphysis centered X-ray beam, D2 and d2 are equivalent, respectively, to the long and the short diameter of the ellipse of the acetabular cup with a hip-centered X-ray beam.

  2. Equals the sum of radiographic anteversion and the responding pelvic tilting.

References

  1. Ackland MK, Bourne WB, Uhthoff HK (1986) Anteversion of the acetabular cup—Measurement of angle after total hip replacement. J Bone Joint Surg 86B:409–413

    Google Scholar 

  2. Aubry S, Marinescu A, Forterre O et al (2005) Definition of a reproducible method for acetabular anteversion measurement at CT. J Radiol 86:399–404

    PubMed  CAS  Google Scholar 

  3. Bader R, Barbano R, Wörtler K et al (2004) Positionsbestimmung an der künstlichen Hüftpfanne mittels Standard-Röntgenaufnahmen: Einfluss der Beckenkippung. Orthopädische Praxis, Sonderausgabe 2004:242–243

    Google Scholar 

  4. Bader R, Steinhauser E, Scholz R et al (2004) Experimentelle Analyse von neutralen, asymmetrischen und Schnapp-Pfannen für die Hüftendoprothetik: Untersuchungen zur Range of Motion und Luxationssicherheit. Z Orthop 142:577–585

    Article  PubMed  CAS  Google Scholar 

  5. Eddine TA, Migaud H, Chantelot C et al (2001) Variations of pelvic anteversion in lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of prosthetic cup. Surg Radiol Anat 23:105–110

    Article  PubMed  CAS  Google Scholar 

  6. Haenle M, Mittelmeier W, Barbano R et al (2006) Intra- und Interobserver-Reliabilität verschiedener Methoden zur Positionsbestimmung künstlicher Hüftpfannen. Orthopädische Praxis, Sonderausgabe 2004:233

    Google Scholar 

  7. Hassan DM, Johnston GHF, Dust WNC et al (1995) Radiographic calculation of the anteversion in acetabular prostheses. Arthroplasty 10:369–372

    Article  CAS  Google Scholar 

  8. Hedlundh U, Hybbinette CH, Fredin H et al (1995) Dislocations and the femoral head size in primary total hip arthroplasty. Clin Orthop 333:226–233

    Google Scholar 

  9. Jamaraz B, Nikou C, Simon DA et al (1997) Range of motion after total hip arthroplasty: experimental verification of the analytical simulator. Tech Rep CMU-RI-TR-97-09, Robotics Institute, Carnegie Mellon University, February 1997

  10. Kalteis T, Handel M, Herold T et al (2006) Position of the acetabular cup—accuracy of radiographic calculation compared to CT-based measurement. Eur J Radiol 58:294–300

    Article  PubMed  Google Scholar 

  11. Kummer FJ, Shah S, Iyer S et al (1999) The effect of acetabular cup orientations on limiting hip rotation. J Arthroplasty 14:509–513

    Article  PubMed  CAS  Google Scholar 

  12. Lazennec JY, Ramare S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9:47–55

    Article  PubMed  CAS  Google Scholar 

  13. Lazennec JY, Charlot N, Gorin M et al (2004) Hip–spine relationship: a radio-anatomical study for optimization in acetabular cup positioning. Surg Radiol Anat 26:136–144

    Article  PubMed  Google Scholar 

  14. Lembeck B, Mueller O, Reize P et al (2004) Einfluss der Beckenkippung auf die radiologischen Messungen von Implantationswinkeln der Hüftpfanne. Z Orthop 141:S64

    Google Scholar 

  15. Müller O, Lembeck B, Reize P et al (2005) Quantifizierung und Visualisierung des Einflusses der Beckenkippung auf die Messung von Pfanneninklination und -anteversion. Z Orthop 143:72–78

    Article  PubMed  Google Scholar 

  16. Murray DW (1993) The definition and measurement of acetabular orientation. J Bone Joint Surg 75B:228–232

    Google Scholar 

  17. Nikou C, Jaramaz B, DiGioia AM et al (2000) Description of anatomic coordinate systems and rationale for use in an image-guided total hip replacement system. Lecture Notes Comput Sci 1935:1188–1194

    Google Scholar 

  18. Nishihara S, Sugano N, Nishii T et al (2003) Measurements of pelvic flexion angle using three dimensional computed tomography. Clin Orthop 411:140–151

    Article  PubMed  Google Scholar 

  19. Olivecrona H, Weidenhielm L, Olivecrona L et al (2004) A new CT method for measuring cup orientation after total hip arthroplasty: a study of 10 patients. Acta Orthop Scand 75:252–260

    Article  PubMed  Google Scholar 

  20. Pettersson H, Gentz CF, Lindberg HO et al (1982) Radiologic evaluation of the position of the acetabular component of the total hip prosthesis. Acta Radiol Diagn 23:259–263

    CAS  Google Scholar 

  21. Pradhan R (1999) Planar anteversion of the acetabular cup as determined from plain anteroposterior radiographs. J Bone Joint Surg 81B:431–435

    Article  Google Scholar 

  22. Tannast M, Murphy S, Langlotz F et al (2006) Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameter. Skeletal Radiol 35:149–155

    Article  PubMed  CAS  Google Scholar 

  23. Widmer KH (2004) A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty 19:387–390

    Article  PubMed  Google Scholar 

  24. Wolf A, Digioia AM 3rd, Mor AB et al (2005) A kinematic model for calculating cup alignment error during total hip arthroplasty. J Biomech 11:2257–2265

    Article  Google Scholar 

  25. Zilber S, Lazennec J-Y, Gorin M et al (2004) Variations of the caudal, central and cranial acetabular anteversion according to the tilt of the pelvis. Surg Radiol Anat 26:456–462

    Article  Google Scholar 

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Authors and Affiliations

  1. Orthopädische Klinik und Poliklinik, Universität Rostock, Doberaner Straße 142, 18057, Rostock, Germany

    M. Haenle, A. Heitner, W. Mittelmeier, R. Barbano & R. Bader

  2. Klinik und Poliklinik für Orthopädie, Universität Leipzig, Leipzig, Germany

    R. Scholz

  3. Klinik für Orthopädie und Unfallchirurgie, Technische Universität München, München, Germany

    E. Steinhauser

Authors
  1. M. Haenle
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  2. A. Heitner
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  3. W. Mittelmeier
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  4. R. Barbano
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  5. R. Scholz
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  6. E. Steinhauser
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  7. R. Bader
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Correspondence to M. Haenle.

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Haenle, M., Heitner, A., Mittelmeier, W. et al. Assessment of cup position from plain radiographs: impact of pelvic tilting. Surg Radiol Anat 29, 29–35 (2007). https://doi.org/10.1007/s00276-006-0167-z

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  • DOI: https://doi.org/10.1007/s00276-006-0167-z

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