Department of Orthopedics, Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008, Zurich, Switzerland.
Arch Orthop Trauma Surg. 2023 Sep;143(9):5977-5984. doi: 10.1007/s00402-023-04825-x. Epub 2023 Mar 11.
Accurate measurement of combined component anteversion (CA) is important in evaluating the radiographic outcomes following total hip arthroplasty (THA). The aim of the present study was to evaluate the accuracy and reliability of a novel radiographic method in estimating CA in THA.
The radiographs and computer tomography of patients who underwent a primary THA were retrospectively reviewed, to measure the radiographic CA (CAr), defined as the angle between a line connecting the center of the femoral head to the most anterior rim of the acetabular cup and a line connecting the center of the femoral head to the base of the femoral head to allow a comparison with the CA measured on the CT (CACT). Subsequently, a computational simulation was performed to evaluate the effect of cup anteversion, inclination, stem anteversion, and leg rotation on the CAr and develop a formula that would correct the CAr according to the acetabular cup inclination based on the best-fit equation.
In the retrospective analysis of 154 THA, the average CAr_cor, and CACT were 53 ± 11° and 54 ± 11° (p > 0.05), respectively. A strong correlation was found between CAr and CACT (r = 0.96, p < 0.001), with an average bias of - 0.5° between CAr_cor and CACT. In the computational simulation, the CAr was strongly affected by the cup anteversion, inclination, stem anteversion, and leg rotation. The formula to convert the CAr to CA_cor was: CA-cor = 1.3Car - (17 In (Cup Inclination) - 31.
The combined anteversion measurement of THA components on the lateral hip radiograph is accurate and reliable, implying that it could be routinely used postoperatively but also in patients with persistent complaints following a THA.
Cross-sectional study, Level III.
在评估全髋关节置换术（THA）后的放射学结果时，准确测量组合部件前倾角（CA）非常重要。本研究的目的是评估一种新的放射学方法在估计 THA 中 CA 的准确性和可靠性。
回顾性分析了接受初次 THA 的患者的 X 线片和计算机断层扫描（CT），以测量 X 线片 CA（CAr），定义为连接股骨头中心到髋臼杯最前缘的线与连接股骨头中心到股骨头基底的线之间的角度，以便与 CT 测量的 CA（CACT）进行比较。随后，进行了计算模拟，以评估杯前倾、倾斜、柄前倾和腿旋转对 CAr 的影响，并根据最佳拟合方程，基于髋臼杯倾斜开发一种校正 CAr 的公式。
在 154 例 THA 的回顾性分析中，平均 CAr_cor 和 CACT 分别为 53±11°和 54±11°（p>0.05）。CAr 与 CACT 之间存在很强的相关性（r=0.96，p<0.001），CAr_cor 与 CACT 之间的平均偏差为-0.5°。在计算模拟中，CAr 受杯前倾、倾斜、柄前倾和腿旋转的强烈影响。将 CAr 转换为 CA_cor 的公式为：CA-cor=1.3Car-（17In（Cup Inclination）-31。
THA 组件的联合前倾角测量在髋关节侧位 X 线片上是准确可靠的，这意味着它可以在术后常规使用，也可以用于 THA 后持续抱怨的患者。
横断面研究，III 级。
