Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
Clin Orthop Surg. 2021 Sep;13(3):329-335. doi: 10.4055/cios20274. Epub 2021 Aug 17.
Several methods of measurement of anteversion of acetabular components after total hip arthroplasty (THA) have been described in the literature using plain radiographs or computed tomography (CT) scans. None of these have proved to be the gold standard. We aimed to study the correlation between the CT and radiographic methods of calculation of acetabulum anteversion.
CT scans of the pelvis, anteroposterior (AP) and cross-table lateral (CL) radiographs were obtained in 60 patients who underwent THA two weeks after surgery. Anteversion was measured using Widmer method and Liaw method on AP radiographs, and the ischiolateral method on CL radiographs. Anteversion measured on the CT scan was taken as the reference anteversion and the above measurements were analysed for correlation with the measurements on CT scan. Intraclass correlation coefficients (ICCs) were calculated for both intra- and interobserver reliability.
Mean acetabular version on CL radiographs was 53.1 ± 10.7. Mean version on AP radiographs by Widmer method was 21.4 ± 3.6 and by Liaw method was 20.3 ± 4.8. Mean version on CT scans was 26.02 ± 6.8. There was a good correlation between the acetabular version on CT scans with the version on AP radiographs by Widmer method ( = 0.78, < 0.001) and Liaw method ( = 0.87, < 0.001). Good correlation was seen between the acetabular version on CL radiographs and CT scans ( = 0.91, < 0.001). Also, a good correlation was observed between the acetabular version measurements on CL radiographs and AP radiographs by Widmer method ( = 0.81, < 0.001) or Liaw method ( = 0.70, < 0.001). Excellent inter- and intraobserver reliability were seen for all the measurements.
Calculation of acetabular component version on AP views as well as CL views of plain radiographs showed a strong correlation with the version measurements on CT scans. Good correlations were observed between different techniques of measurement on radiographs. Therefore, all these measurements can be valid methods for assessment of anteversion.
在全髋关节置换术（THA）后，已经有几种描述髋臼组件前倾角的测量方法在文献中被描述，包括使用普通 X 线片或计算机断层扫描（CT）扫描。但这些方法都没有被证明是金标准。我们旨在研究 CT 和放射学方法计算髋臼前倾角之间的相关性。
对 60 例术后两周行 THA 的患者进行骨盆 CT 扫描、前后位（AP）和交叉侧位（CL）X 线片检查。使用 Widmer 法和 Liaw 法在 AP 片上测量前倾角，在 CL 片上测量坐骨外侧法。将 CT 扫描上测量的前倾角作为参考前倾角，并对上述测量值与 CT 扫描上的测量值进行相关性分析。计算了内部和观察者之间的组内相关系数（ICC）。
CL 片上髋臼平均角度为 53.1°±10.7°。Widmer 法 AP 片上的平均角度为 21.4°±3.6°，Liaw 法为 20.3°±4.8°。CT 扫描上的平均角度为 26.02°±6.8°。CT 扫描上的髋臼角度与 Widmer 法（ = 0.78， < 0.001）和 Liaw 法（ = 0.87， < 0.001）AP 片上的髋臼角度有很好的相关性。CL 片上髋臼角度与 CT 扫描之间也有很好的相关性（ = 0.91， < 0.001）。CL 片上髋臼角度与 Widmer 法（ = 0.81， < 0.001）或 Liaw 法（ = 0.70， < 0.001）AP 片上的髋臼角度测量值之间也有很好的相关性。所有测量值的观察者内和观察者间可靠性均很好。
AP 视图和 CL 视图上髋臼组件角度的计算与 CT 扫描上的角度测量有很强的相关性。在 X 线上的不同测量技术之间观察到了良好的相关性。因此，所有这些测量方法都可以作为前倾角评估的有效方法。
