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International Orthopaedics
Published in: International Orthopaedics 4/2017

01-04-2017 | Original Paper

Accuracy of measuring acetabular cup position after total hip arthroplasty: comparison between a radiographic planning software and three-dimensional computed tomography

Authors: Vahdettin Bayraktar, Markus Weber, Frederik von Kunow, Florian Zeman, Benjamin Craiovan, Tobias Renkawitz, Joachim Grifka, Michael Woerner

Published in: International Orthopaedics | Issue 4/2017

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Abstract

Purpose

Various methods are available for measuring acetabular cup position after total hip arthroplasty (THA) on standard anterior-posterior (AP) radiographs. We compared the accuracy of a commercial radiographic planning software program with that of three-dimensional computed tomography (3D-CT) scans.

Methods

We obtained plain AP radiographs and 3D-CTs from 65 patients after THA. In addition to calculating cup anteversion and inclination with 3D-CT, we determined the cup position using the radiographic planning software program mediCAD® 2.5 (Hectec, Niederviehbach, Germany). Furthermore, we compared the measurements using the inter-teardrop and bi-ischial lines as pelvic landmarks.

Results

The mean difference in anteversion between 3D-CT and mediCAD® software was 0.1° using the inter-teardrop line (standard deviation [SD], 8.8°; range, −21° to 23°; p = 0.97) and 0.4° using the bi-ischial line (SD, 8.8°; range, −23° to 21°; p = 0.72). Inclination showed a mean difference of 0.6° using the inter-teardrop line (SD, 4.4°; range, −9° to 21°; p = 0.24) and 0.5° using bi-ischial line (SD, 4.6°; range, −9° to 22°; p = 0.35). The means for absolute differences were 7.2° for anteversion and 3.1° for inclination. With regard to using the bi-ischial or inter-teardrop line, no significant difference was found between the two pelvic landmarks. The intra-class correlation coefficient (ICC) was analysed for anteversion and inclination using either the inter-teardrop line or the bi-ischial line as radiographic baseline.

Conclusions

A radiographic planning software program (mediCAD®) is a helpful tool for measuring cup inclination on AP radiographs. With respect to anteversion, measurements are rather susceptible to mistakes with mean inaccuracies of over 7°. Thus, 3D-CT remains the “gold standard” if a lower tolerance limit (±3°) is required for more complex biomechanical evaluations. As a pelvic landmark, the interteardrop line is preferential to the bi-ischial line because of its lower impact on the position of the pelvis.
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Metadata
Title
Accuracy of measuring acetabular cup position after total hip arthroplasty: comparison between a radiographic planning software and three-dimensional computed tomography
Authors
Vahdettin Bayraktar
Markus Weber
Frederik von Kunow
Florian Zeman
Benjamin Craiovan
Tobias Renkawitz
Joachim Grifka
Michael Woerner
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 4/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3240-1

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