Carvajal Alba Jaime A, Vincent Heather K, Sodhi Jagdeep S, Latta Loren L, Parvataneni Hari K
Department of Orthopaedics, University of Miami1611 NW 12th Ave. Suite 303. Miami, FL 33136.
Department of Orthopaedics and RehabilitationUniversity of Florida 3450 Hull Road, Gainesville, FL 32607.
Iowa Orthop J. 2017;37:181-187.
Cup position is crucial for optimal outcomes in total hip arthroplasty. Radiographic assessment of component position is routinely performed in the early postoperative period.
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.
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.
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.
These widely used radiographic methods should be interpreted cautiously and computed tomography should be utilized in cases when further intervention is contemplated.
髋臼杯位置对于全髋关节置换术取得最佳疗效至关重要。术后早期通常会对假体位置进行影像学评估。
本研究的目的是在可控环境下确定常规影像学方法能否准确可靠地评估髋臼杯位置，并评估评估者的培训水平是否存在统计学差异。
将骨盆模型安装在空间框架中。将髋臼杯以不同的前倾角和外展角固定。获取标准化的X线片。包括五名接受过专科培训的骨科医生和五名骨科住院医师在内的十名观察者对髋臼杯位置进行了盲法评估。通过骨盆前后位X线片评估外展角，通过髋关节侧位X线片评估前倾角。
所使用的影像学方法显示不够精确，尤其是当髋臼杯处于前倾角和外展角的极端位置时。观察者间具有良好的可靠性（组内相关系数>0.9）。评估者的培训水平不存在差异。
对于这些广泛使用的影像学方法应谨慎解读，在考虑进一步干预的情况下应使用计算机断层扫描。
