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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2013

Open Access 01-12-2013 | Research article

Assessment of cup orientation in hip resurfacing: a comparison of TraumaCad and computed tomography

Authors: Daniel J Westacott, John McArthur, Richard J King, Pedro Foguet

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2013

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Abstract

Purpose

The orientation of the acetabular component in metal-on-metal hip resurfacing arthroplasty affects wear rate and hence failure. This study aimed to establish if interpretation of pelvic radiographs with TraumaCad software can provide a reliable alternative to CT in measuring the acetabular inclination and version.

Methods

TraumaCad was used to measure the acetabular orientation on AP pelvis radiographs of 14 painful hip resurfacings. Four orthopaedic surgeons performed each measurement twice. These were compared with measurements taken from CT reformats. The correlation between TraumaCad and CT was calculated, as was the intra- and inter-observer reliability of TraumaCad.

Results

There is strong correlation between the two techniques for the measurement of inclination and version (p <0.001). Intra- and inter-observer reliability of TraumaCad measurements are good (p <0.001). Mean absolute error for measurement of inclination was 2.1°. TraumaCad underestimated version compared to CT in 93% of cases, by 12.6 degrees on average.

Conclusions

When assessing acetabular orientation in hip resurfacing, the orthopaedic surgeon may use TraumaCad in the knowledge that it correlates well with CT and has good intra- and inter-observer reliability but underestimates version by 12° on average.
Appendix
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Literature
1.
Hart AJ, Buddhdev P, Winship P, Faria N, Powell JJ, Skinner JA: Cup inclination angle of greater than 50 degrees increases whole blood concentrations of cobalt and chromium ions after metal-on-metal hip resurfacing. Hip Int. 2008, 18 (3): 212-219.PubMed
2.
Hart AJ, Ilo K, Underwood R, Cann P, Henckel J, Lewis A, Cobb J, Skinner J: The relationship between the angle of version and rate of wear of retrieved metal-on-metal resurfacings: a prospective, CT-based study. J Bone Joint Surg Br. 2011, 93 (3): 315-320. 10.1302/0301-620X.93B3.25545.CrossRefPubMed
3.
Kwon YM, Glyn-Jones S, Simpson DJ, Kamali A, McLardy-Smith P, Gill HS, Murray DW: Analysis of wear of retrieved metal-on-metal hip resurfacing implants revised due to pseudotumours. J Bone Joint Surg Br. 2010, 92 (3): 356-361. 10.1302/0301-620X.92B3.23281.CrossRefPubMed
4.
Langton DJ, Jameson SS, Joyce TJ, Webb J, Nargol AV: The effect of component size and orientation on the concentrations of metal ions after resurfacing arthroplasty of the hip. J Bone Joint Surg Br. 2008, 90 (9): 1143-1151. 10.1302/0301-620X.90B9.20785.CrossRefPubMed
5.
De Haan R, Campbell PA, Su EP, De Smet KA: Revision of metal-on-metal resurfacing arthroplasty of the hip: the influence of malpositioning of the components. J Bone Joint Surg Br. 2008, 90 (9): 1158-1163. 10.1302/0301-620X.90B9.19891.CrossRefPubMed
6.
Grammatopoulos G, Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gill HS, Murray DW: Optimal acetabular orientation for hip resurfacing. J Bone Joint Surg Br. 2010, 92 (8): 1072-1078. 10.1302/0301-620X.92B8.24194.CrossRefPubMed
7.
Desy NM, Bergeron SG, Petit A, Huk OL, Antoniou J: Surgical variables influence metal ion levels after hip resurfacing. Clin Orthop Relat Res. 2011, 469 (6): 1635-1641. 10.1007/s11999-010-1636-6.PubMedCentralCrossRefPubMed
8.
Cyteval C, Sarrabère MP, Cottin A, Assi C, Morcos L, Maury P, Taourel P: Iliopsoas impingement on the acetabular component: radiologic and computed tomography findings of a rare hip prosthesis complication in eight cases. J Comput Assist Tomogr. 2003, 27 (2): 183-188. 10.1097/00004728-200303000-00014.CrossRefPubMed
9.
Kluess D, Zietz C, Lindner T, Mittelmeier W, Schmitz KP, Bader R: Limited range of motion of hip resurfacing arthroplasty due to unfavorable ratio of prosthetic head size and femoral neck diameter. Acta Orthop. 2008, 79 (6): 748-754. 10.1080/17453670810016803.CrossRefPubMed
10.
Malik A, Maheshwari A, Dorr LD: Impingement with total hip replacement. J Bone Joint Surg Am. 2007, 89 (8): 1832-1842. 10.2106/JBJS.F.01313.CrossRefPubMed
11.
Murray DW: The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993, 75 (2): 228-232.PubMed
12.
Nunley RM, Keeney JA, Zhu J, Clohisy JC, Barrack RL: The reliability and variation of acetabular component anteversion measurements from cross-table lateral radiographs. J Arthroplasty. 2011, 26 (6 Suppl): 84-87.CrossRefPubMed
13.
Langton DJ, Sprowson AP, Mahadeva D, Bhatnagar S, Holland JP, Nargol AV: Cup anteversion in hip resurfacing: validation of EBRA and the presentation of a simple clinical grading system. J Arthroplasty. 2010, 25 (4): 607-613. 10.1016/j.arth.2009.08.020.CrossRefPubMed
14.
15.
Widmer KH: A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty. 2004, 19: 387-390. 10.1016/j.arth.2003.10.016.CrossRefPubMed
16.
Kalteis T, Handel M, Herold T, Perlick L, Paetzel C, Grifka J: Position of the acetabular cup - accuracy of radiographic calculation compared to CT-based measurement. Eur J Radiol. 2006, 58: 294-300. 10.1016/j.ejrad.2005.10.003.CrossRefPubMed
17.
Lazennec JY, Boyer P, Gorin M, Catonné Y, Rousseau MA: Acetabular anteversion with CT in supine, simulated standing, and sitting positions in a THA patient population. Clin Orthop Relat Res. 2011, 469 (4): 1103-1109. 10.1007/s11999-010-1732-7.PubMedCentralCrossRefPubMed
18.
Olivecrona H, Weidenhielm L, Olivecrona L, Beckman MO, Stark A, Noz ME, Maguire GQ, Zeleznik MP, Svensson L, Jonson T: A new CT method for measuring cup orientation after total hip arthroplasty: a study of 10 patients. Acta Orthop Scand. 2004, 75: 252-260. 10.1080/00016470410001169.CrossRefPubMed
19.
Hart AJ, Dandachli W, Schlueter-Brust K, Henckel J, Cobb J: Large ball metal on metal hips obscure cup angle measurement on plain radiographs. Hip Int. 2009, 19 (4): 323-329.PubMed
Metadata
Title
Assessment of cup orientation in hip resurfacing: a comparison of TraumaCad and computed tomography
Authors
Daniel J Westacott
John McArthur
Richard J King
Pedro Foguet
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2013
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-8-8

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