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Skeletal Radiology

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01-03-2006 | Scientific Article

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

Authors: M. Tannast, S. B. Murphy, F. Langlotz, S. E. Anderson, K. A. Siebenrock

Published in: Skeletal Radiology | Issue 3/2006

Abstract

Objective

To compare six different parameters described in literature for estimation of pelvic tilt on an anteroposterior pelvic radiograph and to create a simple nomogram for tilt correction of prosthetic cup version in total hip arthroplasty.

Design

Simultaneous anteroposterior and lateral pelvic radiographs are taken routinely in our institution and were analyzed prospectively. The different parameters (including three distances and three ratios) were measured and compared to the actual pelvic tilt on the lateral radiograph using simple linear regression analysis.

Patients

One hundred and four consecutive patients (41 men, 63 women with a mean age of 31.7 years, SD 9.2 years, range 15.7–59.1 years) were studied.

Results

The strongest correlation between pelvic tilt and one of the six parameters for both men and women was the distance between the upper border of the symphysis and the sacrococcygeal joint. The correlation coefficient was 0.68 for men (P<0.001) and 0.61 for women (P<0.001). Based on this linear correlation, a nomogram was created that enables fast, tilt-corrected cup version measurements in clinical routine use.

Conclusion

This simple method for correcting variations in pelvic tilt on plain radiographs can potentially improve the radiologist’s ability to diagnose and interpret malformations of the acetabulum (particularly acetabular retroversion and excessive acetabular overcoverage) and post-operative orientation of the prosthetic acetabulum.

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Widmer KH. A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty 2004;19:387–90CrossRefPubMed

Fabeck L, Farrokh D, Trolley M, Descamps PY, Gebhart M, Delince P. A method to measure acetabular cup anteversion after total hip replacement. Acta Orthop Belg 1999;65:485–91PubMed

Pradhan R. Planar anteversion of the acetabular cup as determined from plain anteroposterior radiographs. J Bone Joint Surg Br 1999;81:431–5CrossRefPubMed

Falliner A, Muhle C, Brossmann J. Acetabular inclination and anteversion in infants using 3D MR imaging. Acta Radiol 2002;43:221–4PubMedCrossRef

Frick SL, Kim SS, Wenger DR. Pre-and postoperative three-dimensional computed tomography analysis of triple innominate osteotomy for hip dysplasia. J Pediatr Orthop 2000;20:116–23CrossRefPubMed

Tannast M, Langlotz U, Siebenrock KA, Wiese M, Bernsmann K, Langlotz F. Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop Relat Res 2005;436:144–50CrossRefPubMed

Millis MB, Murphy SB. Use of computed tomographic reconstruction in planning osteotomies of the hip. Clin Orthop Relat Res 1992;274:154–9PubMed

Saxler G, Marx A, Vandevelde D, et al. A comparison of free-hand and computer assisted cup placement in total hip arthroplasty-a multi-center study. Z Orthop Ihre Grenzgeb 2004;142:286–91CrossRefPubMed

Olivecrona H, Weidenhielm L, Olivecrona L, et al. A new method for measuring cup orientation after total hip arthroplasty. Acta Orthop Scand 2004;75:252–60PubMedCrossRef

10.

Siebenrock KA, Schöniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion and its treatment by periacetabular osteotomy. J Bone Joint Surg Am 2003;85:278–86PubMed

11.

Mast JW, Brunner RL, Zebrack J. Recognizing acetabular version in the radiographic presentation of hip dysplasia. Clin Orthop Relat Res 2004;418:48–53CrossRefPubMed

12.

Reynolds D, Lucac J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 1999;81:281–8CrossRefPubMed

13.

Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br 1993;75:228–32PubMed

14.

Hassan DM, Johnston GHF, Dust WNC, Watson G, Cassidy D. Radiographic calculation of anteversion in acetabular prosthesis. J Arthroplasty 1995;10:369–72CrossRefPubMed

15.

Thoren B, Sahlstedt B. Influence of pelvic position on radiographic measurements of the prosthetic acetabular component. Acta Radiol 1990;31:133–6PubMed

16.

Sellers RG, Lyles D, Dorr LD. The effect of pelvic rotation on alpha and theta angles in total hip arthroplasty. Contemp Orthop 1988;17:67–70

17.

Siebenrock KA, Kalbermatten DF, Ganz R. Effect of pelvic inclination on determination of acetabular retroversion. A study on cadaver pelves. Clin Orthop Relat Res 2003;407:241–8CrossRefPubMed

18.

Anda S, Svenningsen S, Groentvedt T, Benum P. Pelvic inclination and spatial orientation of the acetabulum. A radiographic, computed tomographic and clinical investigation. Acta Radiol 1990;31:389–94PubMedCrossRef

19.

Eddine TA, Migaud H, Chantelot C, Cotten A, Fontaine C, Duquennoy A. Variations of pelvic anteversion in the lying and standing positions. Analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup. Surg Radiol Anat 2001;23:105–10CrossRefPubMed

20.

Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003;417:112–20PubMed

21.

Nishihara S, Sugano N, Nishii T, Ohzono K, Yoshikawa H. Measurements of pelvic flexion angle using three-dimensional computed tomography. Clin Orthop Relat Res 2003;411:140–51CrossRefPubMed

22.

Kojima A, Nakagawa T, Tohkura A. Simulation of acetabular coverage of femoral head using anteroposterior pelvic radiographs. Arch Orthop Trauma Surg 1998;117:330–6CrossRefPubMed

23.

Konishi N, Mieno T. Determination of acetabular coverage of the femoral head with use of a single anteroposterior radiograph. A new computerized technique. J Bone Joint Surg Am 1993;75:1318–33PubMed

24.

Katada S, Ando K. A rontgenographic evaluation of the indices for hip dysplasia in children influenced by pelvic tilt. In: Ueno R, Akamatsu N, Itami Y, Tagawa H, Yoshino S, editors. The hip. Clinical studies and basic research. Amsterdam: Excerpta Medica; 1984. p. 137–40

25.

Severin E. Contribution to the knowledge of congenital dislocation of the hip joint: late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand 1941;84(Suppl 63):1–142

26.

Tönnis D. General radiography of the hip joint. In: Tönnis D, editor. Congenital dysplasia and dislocation of the hip. Berlin Heidelberg New York: Springer; 1987. p. 100–42

27.

Thoms H. Roentgen pelvimetry as a routine prenatal procedure. Am J Obstet Gynecol 1940;40:891–905

28.

Lehmann KJ, Busch HP, Wischnik A, Georgi M. Obstetric pelvimetry using digital image intensifier radiography (in German). Rofo 1989;151:553–7PubMed

29.

Chan YH. Correlational analysis (Biostatistics 104). Singapore Med J 2003;44:614–9PubMed

30.

McLaren RH. Prosthetic hip angulation. Radiology 1973;107:705–6PubMed

31.

Nishihara S, Sugano N, Nakahodo K, et al. Measurements of pelvic tilting angles during total hip arthroplasty using computer navigation system. In: Delp SL, DiGioia AM, Jaramaz B, editors. Medical image computing and computer-assisted intervention, MICCAI 2000, third international conference, Pittsburgh, Pennsylvania, USA. Berlin Heidelberg New York: Springer; 2000. p. 1176–9

32.

Wagner S, Hofstetter W, Chiquet M, et al. Early osteoartritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthr Cartil 2003;11:508–18CrossRefPubMed

33.

Lierse W. Becken. In: Lanz T, Wachsmuth W, editors. Praktische Anatomie. Berlin Heidelberg New York: Springer; 1984. p. 30–2

34.

Williams PL. The skeleton of the lower limb. In: William PL, Warkick R, Dyson M, Bannister LH, editors. Gray’s anatomy. Edinburgh: Churchill Livingstone; 1989. p. 422–46

Title: Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters
Authors: M. Tannast
S. B. Murphy
F. Langlotz
S. E. Anderson
K. A. Siebenrock
Publication date: 01-03-2006
Publisher: Springer-Verlag
Published in: Skeletal Radiology / Issue 3/2006
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-005-0050-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Estimation of pelvic tilt on anteroposterior X-rays—a comparison of six parameters

Abstract

Objective

Design

Patients

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Patients

Results

Conclusion

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