Jaime A Carvajal Alba1, Heather K Vincent2, Jagdeep S Sodhi3, Loren L Latta4, Hari K Parvataneni5. 1. Department of Orthopaedics, University of Miami1611 NW 12th Ave. Suite 303. Miami, FL 33136. USAjcarvajal@miami.edu. 2. Department of Orthopaedics and RehabilitationUniversity of Florida 3450 Hull Road, Gainesville, FL 32607. USAvincehk@ortho.ufl.edu. 3. BayCare Orthopaedics1160 Kepler Drive, Green Bay, WI 54311. USAJSodhi@baycare.net. 4. Max Biedermann Institute of Biomechanics Department of OrthopaedicsUniversity of Miami 1611 NW 12th Ave. Suite 303. Miami, FL 33136. USALLatta@med.miami.edu. 5. Department of Orthopaedics and RehabilitationUniversity of Florida 3450 Hull Road, Gainesville, FL 32607. USA. parvahk@ortho.ufl.edu.
Abstract
BACKGROUND: Cup position is crucial for optimal outcomes in total hip arthroplasty. Radiographic assessment of component position is routinely performed in the early postoperative period. AIMS: The aims of this study were to determine in a controlled environment if routine radiographic methods accurately and reliably assess the acetabular cup position and to assess if there is a statistical difference related to the rater's level of training. METHODS: A pelvic model was mounted in a spatial frame. An acetabular cup was fixed in different degrees of version and inclination. Standardized radiographs were obtained. Ten observers including five fellowship-trained orthopaedic surgeons and five orthopaedic residents performed a blind assessment of cup position. Inclination was assessed from anteroposterior radiographs of the pelvis and version from cross-table lateral radiographs of the hip. RESULTS: The radiographic methods used showed to be imprecise specially when the cup was positioned at the extremes of version and inclination. An excellent inter-observer reliability (Intra-class coefficient > 0,9) was evidenced. There were no differences related to the level of training of the raters. CONCLUSIONS: These widely used radiographic methods should be interpreted cautiously and computed tomography should be utilized in cases when further intervention is contemplated.
BACKGROUND: Cup position is crucial for optimal outcomes in total hip arthroplasty. Radiographic assessment of component position is routinely performed in the early postoperative period. AIMS: The aims of this study were to determine in a controlled environment if routine radiographic methods accurately and reliably assess the acetabular cup position and to assess if there is a statistical difference related to the rater's level of training. METHODS: A pelvic model was mounted in a spatial frame. An acetabular cup was fixed in different degrees of version and inclination. Standardized radiographs were obtained. Ten observers including five fellowship-trained orthopaedic surgeons and five orthopaedic residents performed a blind assessment of cup position. Inclination was assessed from anteroposterior radiographs of the pelvis and version from cross-table lateral radiographs of the hip. RESULTS: The radiographic methods used showed to be imprecise specially when the cup was positioned at the extremes of version and inclination. An excellent inter-observer reliability (Intra-class coefficient > 0,9) was evidenced. There were no differences related to the level of training of the raters. CONCLUSIONS: These widely used radiographic methods should be interpreted cautiously and computed tomography should be utilized in cases when further intervention is contemplated.
Authors: Benjamin McArthur; Michael Cross; Christina Geatrakas; David Mayman; Bernard Ghelman Journal: Clin Orthop Relat Res Date: 2012-03-01 Impact factor: 4.176
Authors: Shantanu Patil; Arnie Bergula; Peter C Chen; Clifford W Colwell; Darryl D D'Lima Journal: J Bone Joint Surg Am Date: 2003 Impact factor: 5.284