Clinical Orthopedic Research Center - mN, Diakonessenhuis Zeist, Zeist, the Netherlands.
Department of Orthopaedic Surgery, Diakonessenhuis, Utrecht, the Netherlands.
Orthop Surg. 2019 Apr;11(2):241-247. doi: 10.1111/os.12445. Epub 2019 Apr 1.
To determine the comparability among 10 radiographic anteversion methods for acetabular cup orientation in total hip arthroplasty (THA) found in the literature and the "gold" standard of assessing the anteversion with CT.
This is a retrospective study that blindly compares 10 different conventional radiographic anteversion measurements with the "gold" standard, the measurement of anteversion on the transverse plane of the 3-D images made with CT. The patient archiving and communications system (PACS) was systematically searched for subjects that had undergone a CT angiogram of the abdomen and lower extremities, including the pelvis, had at least one THA in situ and had undergone anterior-posterior (AP) and cross-lateral pelvic radiography between January 2013 and August 2016 in the Diakonessenhuis Hospital Utrecht/Zeist, a non-academic institution. CT scans of patients (n = 16) were systematically collected. Three observers independently measured cup anteversion from radiographs, using a total of 10 different methods, and measured the "gold" standard on CT images. The outcomes of the 10 radiographic anteversion were compared in terms of linear correlation with the "gold" standard on CT images.
The correlations of the radiographic measured anteversions with the "gold" standard measured on CT images were 0.528 for the method of Liaw, 0.556 for Wan, 0.562 for the cross-lateral method, 0.586 for Hassan, 0.594 for Dorr, 0.602 for Lewinnek, 0.624 for Widmer, 0.671 for the lateral CT, 0.747 for Ackland, and 0.771 for the method of Riten Pradham.
Anteversion measurement methods represent different projectional angles of the acetabular cup in different planes around different axes. Therefore, they differ from the "gold" standard and are not interchangeable, as is shown by this study. We consider the anatomical anteversion in the transverse plane rotating around the longitudinal axis as the "gold" standard and recommend avoiding using the term anteversion for other projectional angles in different planes.
确定文献中报道的 10 种全髋关节置换术（THA）髋臼杯方向定位的放射学前倾角方法与 CT 评估前倾角的“金标准”之间的可比性。
这是一项回顾性研究，通过 CT 三维图像的横断面对髋臼杯前倾角进行测量，盲法比较了 10 种不同的常规放射学前倾角测量方法与“金标准”的结果。使用患者归档和通信系统（PACS）系统，对 2013 年 1 月至 2016 年 8 月期间在乌德勒支/泽伊斯特的 Diakonessenhuis 医院行腹部和下肢 CT 血管造影检查，包括骨盆，至少有一侧髋关节置换术，并进行前后位（AP）和交叉侧骨盆射线照相的患者进行了系统性搜索。系统地收集了患者的 CT 扫描。三位观察者分别使用总共 10 种不同的方法，从放射影像上独立测量髋臼杯前倾角，并在 CT 图像上测量“金标准”。比较了 10 种放射学前倾角与 CT 图像上“金标准”的线性相关性。
放射学测量的前倾角与 CT 图像上“金标准”的相关性分别为 Liaw 法 0.528、Wan 法 0.556、交叉侧位法 0.562、Hassan 法 0.586、Dorr 法 0.594、Lewinnek 法 0.602、Widmer 法 0.624、侧位 CT 法 0.671、Ackland 法 0.747、Riten Pradham 法 0.771。
前倾角测量方法代表髋臼杯在不同平面围绕不同轴的不同投影角度。因此，正如本研究所示，它们与“金标准”不同，不可互换。我们认为，在围绕纵轴旋转的横断面上的解剖前倾角是“金标准”，并建议避免在不同平面上使用其他投影角度的前倾角术语。
