Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Hip Int. 2020 Sep;30(5):530-535. doi: 10.1177/1120700019859902. Epub 2019 Jun 27.
Supine positioning and the use of fluoroscopy during direct anterior approach total hip arthroplasty (DAA THA) have been reported to improve acetabular component positioning. This study aims to compare 2-dimensional intraoperative radiographic RadLink measurements of acetabular component position with 3-dimensional postoperative 3D SterEOS measurements.
Intraoperative fluoroscopy and RadLink (El Segundo, CA, USA) were used to measure acetabular cup position intraoperatively in 48 consecutive patients undergoing DAA THA. Cup position was measured on 6-week postoperative standing EOS images using 3D SterEOS software (EOS Imaging, SA, Paris, France) and compared to RadLink findings using Student's t-test. Safe-zone outliers were identified. We evaluated for measurement difference of > +/- 5°.
RadLink acetabular cup abduction measurement (mean 43.0°) was not significantly different than 3D SterEOS in the anatomic plane (mean 42.6°, = 0.50) or in the functional plane (mean 42.7°, = 0.61). RadLink acetabular cup anteversion measurement (mean 17.9°) was significantly different than 3D SterEOS in both the anatomic plane (mean 20.6°, = 0.022) and the functional plane (mean 21.2°, = 0.002). RadLink identified 2 cups outside of the safe-zone. However, SterEOS identified 12 (anatomic plane) and 10 (functional plane) outside of the safe-zone. In the functional plane, 58% of anteversion and 92% of abduction RadLink measurements were within +/- 5° of 3D SterEOS.
Intraoperative fluoroscopic RadLink acetabular anteversion measurements are significantly different than 3D SterEOS measurements, while abduction measurements are similar. Significantly more acetabular cups were noted to be outside of the safe-zone when evaluated with 3D SterEOS versus RadLink.
仰卧位和在直接前入路全髋关节置换术（DAA-THA）中使用透视术已被报道可改善髋臼部件的定位。本研究旨在比较二维术中放射学 RadLink 测量与三维术后 3D SterEOS 测量的髋臼部件位置。
在 48 例连续接受 DAA-THA 的患者中，术中使用透视术和 RadLink（El Segundo，CA，美国）在术中测量髋臼杯的位置。在术后 6 周的站立 EOS 图像上使用 3D SterEOS 软件（EOS Imaging，SA，巴黎，法国）测量髋臼杯的位置，并使用学生 t 检验将测量结果与 RadLink 结果进行比较。确定安全区外的结果。我们评估了> +/- 5°的测量差异。
RadLink 髋臼杯外展测量（平均 43.0°）在解剖平面上与 3D SterEOS（平均 42.6°， = 0.50）或功能平面上（平均 42.7°， = 0.61）无显著差异。RadLink 髋臼杯前倾角测量（平均 17.9°）在解剖平面（平均 20.6°， = 0.022）和功能平面（平均 21.2°， = 0.002）上均明显大于 3D SterEOS。RadLink 确定了 2 个杯在安全区外。然而，SterEOS 在解剖平面上确定了 12 个（解剖平面）和 10 个（功能平面）杯在安全区外。在功能平面上，58%的前倾角和 92%的外展角 RadLink 测量值与 3D SterEOS 的测量值相差 +/- 5°以内。
术中透视 RadLink 髋臼前倾角测量值明显不同于 3D SterEOS 测量值，而外展角测量值相似。使用 3D SterEOS 评估时，与 RadLink 相比，明显有更多的髋臼杯被认为超出了安全区。
