Plain Radiographs are a Useful Substitute for Computed Tomography in Evaluating Acetabular Cup Version

Area of Science:

• Orthopedic surgery
• Radiology
• Medical imaging analysis

Background:

• Accurate measurement of acetabular component version is crucial for successful hip arthroplasty outcomes.
• Various imaging modalities are used, including computed tomography (CT) and different radiographic views.
• Standardization and validation of these measurement techniques are essential.

Purpose of the Study:

• To compare the accuracy and reliability of acetabular component version measurements using cross-table lateral (XTL) radiographs, anteroposterior pelvis (AP-P) and anteroposterior hip (AP-H) radiographs, and axial pelvic CT scans.
• To determine the most suitable radiographic method for postoperative assessment of acetabular version.

Main Methods:

• A retrospective analysis of 150 hips with postoperative CT, XTL, and AP-P radiographs was conducted.
• Acetabular component version was measured independently by two authors using each imaging modality.
• Statistical analyses, including Pearson regression and analysis of variance (ANOVA), were used to assess correlations and compare mean values.

Main Results:

• Mean version measurements varied: XTL (21.7°), CT (23.8°), AP-P (12.5°), and AP-H (17.2°).
• XTL and AP-H radiographs showed strong correlation with CT (r=0.81), while AP-P showed moderate correlation (r=0.75).
• XTL measurements were not significantly different from CT (P=0.36), whereas AP-P and AP-H showed significant differences (P<0.05).

Conclusions:

• Cross-table lateral (XTL) radiographs are a reliable, cost-effective, and safer alternative to CT scans for assessing postoperative acetabular component version.
• XTL offers comparable accuracy to CT for supine version assessment in the postoperative setting.
• Radiographic methods like XTL can reduce patient exposure to radiation and healthcare costs.