Effect of pelvic tilt and rotation on cup orientation in standing anteroposterior radiographs

Yun, Ho Hyun; Murphy, William S.; Ward, Daniel M.; Zheng, Guoyan; Hayden, Brett L.; Murphy, Stephen

doi:10.1177/1120700019831665

Cited by 9 publications

(7 citation statements)

References 40 publications

(76 reference statements)

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“…Nevertheless, the X-ray offset was also neglected by the Ackland algorithm used in their method. In another clinical study, Yun et al used 2D-3D matching software to compare the difference in the RA angles between the supine and standing positions and found that there was a negative correlation of the pelvic longitudinal rotation with the RA angle of the right cup but a positive correlation with the left cup in both supine and standing positions (135,136).…”

Section: D-3d Registration Methodsmentioning

confidence: 99%

Radiographic assessment of the cup orientation after total hip arthroplasty: a literature review

Zhao¹,

Su²,

Zhao³

et al. 2020

Ann Transl Med

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Optimal acetabular cup orientation is of substantial importance to good long-term function and low complication rates after total hip arthroplasty (THA). The radiographic anteversion (RA) and inclination (RI) angles of the cup are typically studied due to the practicability, simplicity, and ease of interpretation of their measurements. A great number of methods have been developed to date, most of which have been performed on pelvic or hip anteroposterior radiographs. However, there are primarily two influencing factors for these methods: X-ray offset and pelvic rotation. In addition, there are three types of pelvic rotations about the transverse, longitudinal, and anteroposterior axes of the body. Their effects on the RA and RI angles of the cup are interactively correlated with the position and true orientation of the cup. To date, various fitted or analytical models have been established to disclose the correlations between the X-ray offset and pelvic rotation and the RA and RI angles of the cup. Most of these models do not incorporate all the potential influencing parameters. Advanced methods for performing X-ray offset and pelvic rotation corrections are mainly performed on a single pelvic AP radiograph, two synchronized radiographs, or a two-dimensional/three-dimensional (2D-3D) registration system. Some measurement systems, originally developed for evaluating implant migration or wear, could also be used for correcting the X-ray offset and pelvic rotation simultaneously, but some drawbacks still exist with these systems. Above all, the 2D-3D registration technique might be an alternative and powerful tool for accurately measuring cup orientation.In addition to the current methods used for postoperative assessment, navigation systems and augmented reality are also used for the preoperative planning and intraoperative guidance of cup placement. With the continuing development of artificial intelligence and machine learning, these techniques could be incorporated into robot-assisted orthopaedic surgery in the future.

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Section: D-3d Registration Methodsmentioning

confidence: 99%

Radiographic assessment of the cup orientation after total hip arthroplasty: a literature review

Zhao¹,

Su²,

Zhao³

et al. 2020

Ann Transl Med

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“…With the widespread use of CT, the ACEA CT has begun to be used to determine the anterior coverage of the hip instead of the ACEA FP. The reproducibility of the ACEA CT is better, but its correlation with the ACEA FP in patients with hip dysplasia is not yet clear [ 10 ]. To address these problems, we carried out this study.…”

Section: Discussionmentioning

confidence: 99%

“…The ACEA CT is measured on the CT sagittal plane, which is obtained in the supine position, while the ACEA FP is measured on FP radiographs, which are obtained in the standing position. These variations lead to differences in the measurement results [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Determining anterior hip coverage in patients with hip dysplasia using the anterior center-edge angle on Lequesne’s false-profile radiograph and on computed tomography

Cheng

Zhang

Luo

et al. 2023

Journal of Hip Preservation Surgery

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Anterior hip coverage is important for hip stability. As a parameter of anterior hip coverage, the anterior center-edge angle on false-profile radiograph (ACEA FP) is associated with clinical outcomes. With the widespread application of computed tomography (CT), the anterior center-edge angle on CT (ACEA CT) has also been used to measure anterior hip coverage. Little is known about the reproducibility of the ACEA FP and ACEA CT in patients with hip dysplasia or the correlation between the ACEA CT and ACEA FP. In total, 49 hips of 49 patients who underwent periacetabular osteotomy in our center were included. The lateral center-edge angle, Tönnis angle, ACEA FP and ACEA CT were determined. We assessed the intraobserver and interobserver reliability of the ACEA FP and ACEA CT, the effect of the Tönnis angle on the reliability of the ACEA FP and ACEA CT and the correlation between the ACEA CT and ACEA FP. The intraobserver and interobserver interclass correlation coefficients of the ACEA FP were good, and those of the ACEA CT were very good. The Tönnis angle was weakly correlated with inconsistent ACEA FP measurements (P = 0.008) but not with inconsistent ACEA CT measurements (P = 0.600). No correlation between ACEA FP and ACEA CT measurements was observed (P = 0.213–0.665). The reproducibility of the ACEA CT is more consistent than that of the ACEA FP. The oblique acetabular roof had an effect on determining the ACEA FP but not on determining the ACEA CT. No correlation was observed between the measured ACEA FP and ACEA CT values, so the clinical evidence obtained from the ACEA FP cannot be directly applied to the ACEA CT.

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“…Because standing radiography can recreate the state of the hip during body weight loading, the pelvic tilt was not normalized. [35] On the FP radiographs, the ACEA was measured by the angle between the line joining the midpoint of the femoral head to the anterior rim of the acetabular sourcil and its vertical line. The normal reference value for the ACEA is 20-40°.…”

Section: Methodsmentioning

confidence: 99%

Can we determine anterior hip coverage from pelvic anteroposterior radiographs? A study of patients with hip dysplasia

Cheng

Zhang

Sun

et al. 2023

Preprint

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Purpose: Insufficient coverage causes hip joint instability and results in hip pain. Anterior hip coverage can be determined on both pelvic anteroposterior (AP) radiographs and false profile (FP) radiographs. Four parameters are commonly used to determine the anterior coverage on pelvic AP radiographs: the crossover index, crossover sign, anterior wall index (AWI), and rule of thirds. This study aims to clarify the relationship between these 4 parameters on AP radiographs and the anterior center edge angle (ACEA) on FP radiographs. Methods: In this study, 53 patients who underwent periacetabular osteotomy for hip dysplasia at our center between July 2020 and October 2020 were retrospectively reviewed. Four parameters on AP radiographs and the ACEA on FP radiographs before surgery and 6 months after surgery were measured and compared for each hip. Results: Upon examining the 53 hips in this study, there was no correlation between either the crossover index and the ACEA (P=0.66) or the crossover sign before surgery. The postoperative correlation between the crossover index and the ACEA was weak (r=0.36, P=0.007), and that between the crossover sign and the ACEA was moderate (r=0.41, P=0.003). There was a weak correlation between the AWI and ACEA both before (r=0.288, P=0.036) and after (r=0.349, P=0.011) the operation. Evaluation of the anterior coverage by the rule of thirds was also not consistent when determining the anterior coverage with the ACEA. Conclusion: Anterior coverage on AP radiographs is largely inconsistent with ACEA on FP radiographs, especially before the surgery. It is recommended to take FP radiographs routinely for determining anterior hip coverage.

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Effect of pelvic tilt and rotation on cup orientation in standing anteroposterior radiographs

Cited by 9 publications

References 40 publications

Radiographic assessment of the cup orientation after total hip arthroplasty: a literature review

Radiographic assessment of the cup orientation after total hip arthroplasty: a literature review

Determining anterior hip coverage in patients with hip dysplasia using the anterior center-edge angle on Lequesne’s false-profile radiograph and on computed tomography

Can we determine anterior hip coverage from pelvic anteroposterior radiographs? A study of patients with hip dysplasia

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