Reliability and Validity of Standing Lateral Radiograph Method for Measuring Acetabular Component Version: A Modified...

Area of Science:

• Orthopedic Surgery
• Radiology
• Medical Imaging

Background:

• Accurate measurement of acetabular component version is crucial for successful total hip arthroplasty (THA) outcomes.
• Traditional methods like cross-table lateral (CL) radiography can be prone to measurement errors due to pelvic tilt.
• Standing lateral (SL) radiography offers a potential alternative for more accurate cup version assessment.

Purpose of the Study:

• To evaluate the impact of X-ray incidence angle on cup version measurements.
• To determine the reliability and validity of standing lateral (SL) radiography for measuring cup versions.
• To compare SL radiography measurements with computed tomography (CT) scans.

Main Methods:

• 3D simulation analysis was used to investigate cup versions under varying X-ray incidence angles.
• Retrospective analysis of 93 patients who underwent primary THA, comparing SL radiographs with CT scans.
• Cup versions were measured by two orthopedic physicians, with intra- and inter-observer reliabilities assessed using intra-class correlation coefficient (ICC).

Main Results:

• No significant differences in cup version measurements were found across different X-ray incidence angles (P = 0.663).
• Excellent intra- and inter-observer reliabilities were achieved (ICC > 0.95).
• SL radiograph measurements showed strong correlation with CT scans (r = 0.853, P < 0.001), with a mean difference of -0.49°.

Conclusions:

• Standing lateral (SL) radiography provides cup version measurements comparable to CT scans.
• The SL radiography method demonstrates high reliability and validity for assessing acetabular component version post-THA.
• SL radiography is a dependable tool for postoperative evaluation of cup version in total hip arthroplasty.