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Validation of a Novel Method of Measuring Cup Orientation Using BiPlanar Simultaneous Radiographic Images.

Daniel C Sun1, William S Murphy2, Andrew J Amundson3

  • 1Tufts Medical Center, Boston, Massachusetts.

The Journal of Arthroplasty
|April 19, 2023
PubMed
Summary

A new method using simultaneous biplanar X-rays accurately measures acetabular cup position in total hip arthroplasty (THA), offering a reliable alternative to CT scans for surgical planning.

Keywords:
acetabular cuparthroplastybiplanar radiographspostoperative measurementtotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Accurate acetabular component positioning is critical for total hip arthroplasty (THA) success.
  • Traditional 2D imaging has limitations in assessing implant position.
  • Investigating novel imaging techniques is essential for improving THA outcomes.

Purpose of the Study:

  • To evaluate the accuracy and reproducibility of a new method for measuring acetabular component position.
  • To compare measurements from simultaneous orthogonal biplanar X-rays with computed tomography (CT) scans.
  • To determine the clinical utility of biplanar radiography in THA component assessment.

Main Methods:

  • Forty patients with prior contralateral THA underwent both CT and simultaneous orthogonal biplanar radiographic scans.
  • A novel measurement technique was used to calculate operative inclination (OI) and operative anteversion (OA) from biplanar scans.
  • Measurements were compared to CT scans, with two independent observers assessing reliability.

Main Results:

  • The mean error for operative anteversion (OA) was 0.5° (SD: 1.9°) and for operative inclination (OI) was 0.0° (SD: 1.7°).
  • Average absolute errors were 1.5° for OA and 1.2° for OI.
  • High interobserver correlation coefficients of 0.83 for OA and 0.93 for OI indicate strong reliability.

Conclusions:

  • The novel method using simultaneous biplanar radiographic scans is accurate for measuring acetabular cup orientation.
  • This technique demonstrates high reproducibility between observers when compared to CT measurements.
  • Biplanar radiography offers a viable and accurate alternative for assessing acetabular component position in THA.