Biplanar Low-Dose Radiography Is Accurate for Measuring Combined Anteversion After Total Hip Arthroplasty

Overview

Journal HSS J

Date 2020 Feb 5

PMID 32015737

Citations 6

Authors

Christina I Esposito

Theodore T Miller

Joseph D Lipman

Kaitlin M Carroll

Douglas E Padgett

David J Mayman

Seth A Jerabek

Affiliations

Soon will be listed here.

Abstract

Background: Acetabular component position alone has not been predictive of stability after total hip arthroplasty (THA). Combined anteversion of the acetabulum and femur has the potential of being more predictive of stability. Unfortunately, femoral component position is difficult to measure on plain radiographs. Computed tomography (CT) is the gold standard for measuring implant position post-operatively, but CT exposes patients to a substantial amount of radiation.

Questions/purposes: We sought to determine whether biplanar low-dose radiography can be used to accurately measure both acetabular and femoral implant position after THA.

Methods: Twenty patients underwent standing low-dose biplanar spine-to-ankle radiographs and supine CT scans 6 weeks after THA. Measurements of acetabular inclination, acetabular anteversion, and femoral anteversion were performed by two blinded observers and compared.

Results: The average absolute differences between biplanar radiographs and CT scans were 2° ± 2° for acetabular inclination, 3° ± 2° for acetabular anteversion, and 4° ± 4° for femoral anteversion between EOS measurements and CT measurements. Interobserver agreement was good for acetabular inclination, acetabular anteversion, and femoral anteversion (Cronbach's = 0.90) using biplanar low-dose imaging.

Conclusion: Biplanar radiography is a reliable low-radiation alternative for measuring acetabular inclination, acetabular anteversion, femoral version, and thus combined anteversion compared to CT. Femoral anteversion had the most variability but is still clinically relevant.

Citing Articles

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Reliability and validity of the functional combined anteversion measurement method using standing lateral radiography after total hip arthroplasty.

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van Erp J, Snijders T, Weinans H, Castelein R, Schlosser T, de Gast A Arch Orthop Trauma Surg. 2021; 142(6):1253-1264.

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Kim J, Lee D, Lee H, Shin H, Park B, Park S Sci Rep. 2021; 11(1):10468.

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Mittal A, Kumar N, Nandimandalam B, Pankaj A J Clin Orthop Trauma. 2021; 15:104-109.

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