A simplified method to determine acetabular cup anteversion from plain radiographs

Plain radiographs are the most important diagnostic means for determining the indication and following up on total hip arthroplasty. The acetabular cup position can be easily determined by applying trigonometric functions. This report presents an even simpler method. The short axis of the projected ellipse is measured and related to the total cross-section of the projected cup along the short axis. This relationship correlates with acetabular cup anteversion angles and represents an inverse sinus function. A close linear correlation is seen within the most common interval from 10 degrees to 30 degrees. Anteversion is between 23 degrees to 24 degrees when the ellipse bisects the total acetabular cross-section. This means that simply measuring the length of the short ellipse axis and the total length of the projected cross-section along the short axis provides the radiographic acetabular anteversion. Nonorthogonal projected radiographs should be corrected first.