TY - JOUR
T1 - CT outperforms radiography for determination of acetabular cup version after THA
AU - Ghelman, Bernard
AU - Kepler, Christopher K.
AU - Lyman, Stephen
AU - Della Valle, Alejandro González
N1 - Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2009/9
Y1 - 2009/9
N2 - Precise evaluation of acetabular cup version is necessary for patients with recurrent hip dislocation after THA. We retrospectively studied 42 patients, who underwent THAs, with multiple cross-table lateral radiographs and CT scans to determine whether radiographic or CT measurement of acetabular component version is more accurate. One observer measured cup version on all radiographs. CT scans were interpreted by one observer. Twenty radiographs were measured twice each by two observers to determine intraobserver and interobserver reliability. We implanted cups in four model pelvises using navigation and compared measurements of anteversion made with radiographs and CT scans. Intraclass correlation coefficients (ICC) for anteversion measurements of two observers were 0.9990 and 0.9998, respectively, when comparing measurements of identical radiographs (intraobserver). Paired values for two observers measuring the same radiograph had an ICC of 0.9686 (interobserver) compared with 0.7412 for measurements from serial radiographs of the same component. The ICC comparing radiographic versus CT-based measurements was 0.6981. CT measurements had stronger correlations with navigated values than radiographic measurements. Accuracy of anteversion measurements on cross-table radiographs depends on radiographic technique and patient positioning whereas properly performed CT measurements are independent of patient position. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
AB - Precise evaluation of acetabular cup version is necessary for patients with recurrent hip dislocation after THA. We retrospectively studied 42 patients, who underwent THAs, with multiple cross-table lateral radiographs and CT scans to determine whether radiographic or CT measurement of acetabular component version is more accurate. One observer measured cup version on all radiographs. CT scans were interpreted by one observer. Twenty radiographs were measured twice each by two observers to determine intraobserver and interobserver reliability. We implanted cups in four model pelvises using navigation and compared measurements of anteversion made with radiographs and CT scans. Intraclass correlation coefficients (ICC) for anteversion measurements of two observers were 0.9990 and 0.9998, respectively, when comparing measurements of identical radiographs (intraobserver). Paired values for two observers measuring the same radiograph had an ICC of 0.9686 (interobserver) compared with 0.7412 for measurements from serial radiographs of the same component. The ICC comparing radiographic versus CT-based measurements was 0.6981. CT measurements had stronger correlations with navigated values than radiographic measurements. Accuracy of anteversion measurements on cross-table radiographs depends on radiographic technique and patient positioning whereas properly performed CT measurements are independent of patient position. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
UR - http://www.scopus.com/inward/record.url?scp=69249214257&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69249214257&partnerID=8YFLogxK
U2 - 10.1007/s11999-009-0774-1
DO - 10.1007/s11999-009-0774-1
M3 - Article
C2 - 19277802
AN - SCOPUS:69249214257
VL - 467
SP - 2362
EP - 2370
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
SN - 0009-921X
IS - 9
ER -