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Do fluoroscopy and postoperative radiographs correlate for periacetabular osteotomy corrections?
Charles L Lehmann1, Jeffrey J Nepple, Geneva Baca
1Department of Orthopaedic Surgery, Washington University School of Medicine, 660 S Euclid, 11300 West Pavilion, Campus Box 8233, St Louis, MO 63110, USA.
Clinical Orthopaedics and Related Research
|August 29, 2012
Summary
Intraoperative fluoroscopy for Bernese periacetabular osteotomy (PAO) correlates well with postoperative radiographs for acetabular correction. The lateral center-edge angle shows the strongest agreement, aiding surgical assessment.
Area of Science:
- Orthopedic surgery
- Radiology
- Biomedical imaging
Background:
- Bernese periacetabular osteotomy (PAO) aims to relieve pain and improve function in acetabular dysplasia.
- Accurate acetabular correction is crucial for PAO success and long-term implant survival.
- Intraoperative fluoroscopy is used to guide acetabular correction, but its accuracy compared to postoperative radiography is uncertain.
Purpose of the Study:
- To determine the correlation between acetabular correction parameters measured during intraoperative fluoroscopy and those on postoperative radiographs following PAO.
Main Methods:
- Retrospective review of 48 patients (50 hips) who underwent PAO.
- Intraoperative fluoroscopic images (AP and false profile) were compared with postoperative standing AP pelvis and false profile radiographs.
- Standard measurements of acetabular position were used to assess correction.
Main Results:
- Lateral center-edge angle demonstrated the highest correlation (ICC=0.80) between intraoperative fluoroscopy and postoperative radiography.
- Acetabular inclination (ICC=0.76) and anterior center-edge angle (ICC=0.71) also showed good correlation.
- Extrusion index (ICC=0.66) and medial offset distance (ICC=0.46) had lower correlations.
Conclusions:
- Intraoperative fluoroscopic assessment of PAO acetabular correction is reliable and correlates with postoperative radiographic findings.
- Lateral center-edge angle measurement offers the highest correlation and fewest outliers.
- While acetabular inclination and anterior center-edge angle also correlate, extrusion index and medial offset distance require cautious interpretation.
