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Archives of Orthopaedic and Trauma Surgery

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01-08-2018 | Orthopaedic Surgery

Assessment of pelvic tilt in anteroposterior radiographs by means of tilt ratios

Authors: T. Schwarz, A. Benditz, H.-R. Springorum, J. Matussek, G. Heers, M. Weber, T. Renkawitz, J. Grifka, B. Craiovan

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2018

Abstract

Introduction

In anteposterior (AP) radiographs, cup position in total hip arthroplasty and acetabular anatomy in hip-preserving surgery are highly influenced by pelvic tilt. The sagittal rotation of the anterior pelvic plane is an important measurement of pelvic tilt during hip surgery. Thus, correct evaluation of cup position and acetabular parameters requires the assessment of pelvic tilt in AP radiographs.

Methods

Changes in pelvic tilt inversely change the height of the lesser pelvis and the obturator foramen in AP radiographs. Tilt ratios were calculated by means of these two parameters in simulated radiographs for ten male and ten female pelvises in defined tilt positions. A tilt formula obtained by exponential regression analysis was evaluated by two blinded investigators by means of 14 simulated AP radiographs of the pelvis with pelvic tilts ranging from + 15° to − 15°.

Results

No differences were found between male and female tilt ratios for each 5° step of simulated pelvic tilt. Pelvic tilt and tilt ratios correlated exponentially. Using the tilt formula, the two blinded investigators were able to assess pelvic tilt with high conformity, a mean relative error of + 0.4° (SD ± 4.6°), and a mean absolute error of 3.9° (SD ± 2.3°). Neutral pelvic tilt is indicated by a tilt ratio of 0.5 when the height of the lesser pelvis is twice the height of the obturator foramen.

Conclusion

The analysis and interpretation of cup position and acetabular parameters may be improved by our method for assessing pelvic tilt in AP radiographs.

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Title: Assessment of pelvic tilt in anteroposterior radiographs by means of tilt ratios
Authors: T. Schwarz
A. Benditz
H.-R. Springorum
J. Matussek
G. Heers
M. Weber
T. Renkawitz
J. Grifka
B. Craiovan
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2931-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of pelvic tilt in anteroposterior radiographs by means of tilt ratios

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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