Department of Orthopaedic Surgery, Washington University School of Medicine, 660 S Euclid, 11300 West Pavilion, Campus Box 8233, St Louis, MO 63110, USA.
Clin Orthop Relat Res. 2012 Dec;470(12):3508-14. doi: 10.1007/s11999-012-2483-4. Epub 2012 Aug 28.
The Bernese periacetabular osteotomy (PAO) can relieve pain and restore function in patients with symptomatic acetabular dysplasia. Accurate acetabular correction is fundamental to achieving these clinical goals and presumably enhancing survivorship of the reconstruction. Fluoroscopy is used by some surgeons to assess intraoperative acetabular correction but it is unclear whether the features observed by fluoroscopy accurately reflect those on postoperative radiographs.
QUESTIONS/PURPOSES: We therefore determined whether the parameters of acetabular correction of PAO correlated on intraoperative fluoroscopic imaging and postoperative radiography.
We retrospectively reviewed the imaging of 48 patients (50 hips) who underwent PAO. Intraoperative fluoroscopic AP and false profile images were obtained after final PAO correction. The intraoperative deformity correction as measured on the two fluoroscopy views was compared with the correction determined with postoperative standing plain AP pelvis and false profile radiographs using common measurements of acetabular position.
Of all radiographic parameters, lateral center-edge angle had the highest correlation between intraoperative fluoroscopy and the postoperative radiograph with an intraclass correlation coefficient (ICC) of 0.80 (0.68-0.88). Similarly, acetabular inclination and anterior center-edge angle also correlated with ICCs of 0.76 (0.61-0.85) and 0.71 (0.54-0.82), respectively. Extrusion index and medial offset distance had lower correlations with ICCs of 0.66 (0.46-0.79) and 0.46 (0.21-0.65), respectively.
Intraoperative fluoroscopic assessment of PAO correction correlated with that from the postoperative radiographic assessment. Measurement of lateral center-edge angle shows the highest correlation with the fewest outliers. Acetabular inclination and anterior center-edge angle also correlated; extrusion index and medial offset distance should be used with more caution.
伯尔尼髋臼周围截骨术（PAO）可缓解髋臼发育不良患者的疼痛并恢复其功能。准确的髋臼矫正对于实现这些临床目标至关重要，并且可能会提高重建的存活率。一些外科医生使用荧光透视术来评估术中髋臼矫正情况，但尚不清楚荧光透视术中观察到的特征是否准确反映了术后 X 光片上的特征。
问题/目的：因此，我们确定 PAO 术中髋臼矫正的参数是否与术中荧光透视成像和术后 X 光片相关。
我们回顾性分析了 48 例（50 髋）接受 PAO 的患者的影像学资料。在最终 PAO 矫正后获得术中荧光透视前后位和假斜位图像。使用髋臼位置的常见测量方法，比较两种荧光透视视图上测量的术中畸形矫正与术后站立位骨盆前后位 X 光片和假斜位 X 光片上确定的矫正。
在所有放射学参数中，外侧中心边缘角在术中荧光透视和术后 X 光片之间具有最高的相关性，组内相关系数（ICC）为 0.80（0.68-0.88）。同样，髋臼倾斜度和前中心边缘角也与 ICC 相关，分别为 0.76（0.61-0.85）和 0.71（0.54-0.82）。挤出指数和内侧偏移距离的相关性较低，ICC 分别为 0.66（0.46-0.79）和 0.46（0.21-0.65）。
PAO 矫正的术中荧光透视评估与术后放射学评估相关。外侧中心边缘角的测量具有最高的相关性，且离群值最少。髋臼倾斜度和前中心边缘角也具有相关性；挤出指数和内侧偏移距离应谨慎使用。
