Measurement of rotational deformity: using a smartphone application is more accurate than conventional methods

Graham, David; Suzuki, Arnold; Reitz, C; Saxena, Akshat; Kuo, Judy; Tetsworth, Kevin

doi:10.1111/ans.12371

Cited by 15 publications

(24 citation statements)

References 11 publications

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“…A systematic review of the literature [ 16 ] described all validated accelerometer-, magnetometer-, and photographic-based smartphone applications used as goniometers for peripheral joints and the spine. Researchers in Australia [ 17 ] more accurately measured the rotational deformity of a correction osteotomy using an application for iPhone. Peters et al [ 18 ] used an iPhone for acetabular cup placement in THA.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up

et al. 2017

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ObjectivesLong-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing.MethodsWe propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden.ResultsThe estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied.ConclusionsWe propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

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Section: Introductionmentioning

confidence: 99%

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up

et al. 2017

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“…indicated that this measurement method could generate an acceptable result. One study to measure the angle between two fixed Kirschner wires in four saw bone models demonstrated high accuracy and precision of smartphone measurement during rotational deformity assessment . Another study to assess its clinical suitability to correct the intraoperative femoral malrotation in patients with femoral nailing fixation demonstrated similar results …”

Section: Introductionmentioning

confidence: 95%

Evaluation of the smartphone for measurement of femoral rotational deformity

Shen

Huang

et al. 2019

ANZ Journal of Surgery

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Background: A novel measurement technique has been designed to assess femoral rotation deformation. The purpose of this study was to evaluate smartphone-aided measurement, including measurement software, intra-observer differences and the occurrence frequency of the unacceptable outliers. Methods: Five positions (intact bone, external and internal rotations of 20 and 40 of the distal blocks after dividing the femoral shafts using a saw) were used in each of the five artificial femora. Guide wires were separately inserted into the proximal and distal ends of the model femora with a navigation system and the intersection angles between the guide wires were measured with a smartphone. The values obtained by two measurement software packages (Smart Tools and Super Swiss Army Knife) were compared with that measured on the overlapped computed tomography images. Results: There were no significant differences between the intersection angles measured by smartphone and that measured on the overlapped images (P = 0.24). The mean absolute difference between pairs of measurements of the two software packages for all guide wire angles was 2.33 AE 2.34 , without statistically significant difference (P = 0.33). There was a significant correlation (r = 0.99) between the first and second (1 week apart) measurements with the same measurement tool. The values of offset capability index of the Smart Tools and the Super Swiss Army Knife measurement tools were 1.62 and 1.13, respectively. Conclusion: Smartphone-aided measurement technique could reliably assess femoral rotation deformation with more accurate angle measurement for software with zero calibration function.

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“…These techniques are user-dependent, and they are susceptible to inaccuracy and error. 2,[4][5][6][7] Over-correction and under-correction have been reported in the literature with error rates as high as 10%. 8 Furthermore, it is known that measured rotation at the time of surgery differs from post-operative radiographic measurements in up to 50% of cases.…”

Section: Introductionmentioning

confidence: 99%

“…8,10 Inclinometers and smart phone inclinometer applications have been recently used clinically in an attempt improve accuracy. 7 Traditionally, electronic inclinometers have been used by carpenters, surveyors, and engineers to assess tilt or slope. Electronic inclinometers have demonstrated accuracy in measuring static rotational differences as well as improving accuracy in total knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

“…Electronic inclinometers have demonstrated accuracy in measuring static rotational differences as well as improving accuracy in total knee arthroplasty. 7,11 However, there have been no studies to our knowledge assessing the use of an electronic inclinometer in performing derotational osteotomies. This study was designed to assess the accuracy of femoral derotation osteotomies performed using an electronic inclinometer, compared to commonly used visual techniques.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the use of an electronic inclinometer in correcting rotational disorders of the hip in children

Swarup

Goodbody

Gausden

et al. 2019

Journal of Clinical Orthopaedics and Trauma

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Study Participants & Setting: Studies comparing two or more treatments for hip subluxation in CP for patients aged <21 and reporting rates of resubluxation or reoperation were included. Materials/Methods: Pubmed, EMBASE, and Cochrane were systematically searched from 1953-January 13th, 2017, inclusive for comparative studies treating hip subluxation/dislocation in children with CP. Studies were screened for inclusion and characteristics including study design, demographics, radiographic parameters (Migration Index and Neck-Shaft Angle), and frequency of resubluxations/reoperations were extracted in duplicate. Studies were graded for quality using the Newcastle Ottawa Scale. Pooled risk estimates (odds ratio for resubluxation/reoperations) were obtained using a fixed effects model due to the low heterogeneity (I2<50). No publication bias was identified. This meta-analysis was performed and reported in accordance with PRISMA guidelines. Results: Ten retrospective cohort studies were included. Two comparison groups were identified: Combined femoral and pelvic osteotomies vs femoral osteotomies, and femoral osteotomies vs soft-tissue surgery. 10.4% of combined osteotomies had hip resubluxation/reoperation compared to 14.5% for femoral osteotomies alone. The odds ratio for resubluxation/ reoperation was not statistically different for combined osteotomies compared to femoral alone, as shown in Figure 1 (OR=0.59 95%CI: 0.31-1.14). 49.3% of femoral osteotomies had resubluxation/reoperation, compared to 64.4% of soft tissue surgeries. The odds ratio for resubluxation/reoperation was decreased for femoral osteotomies compared to soft tissue procedures, shown in Figure 2 (OR=0.38 95%CI: 0.17-0.86). Conclusions/Significance: Resubluxation/reoperation rates were high. Although there may be a role for soft tissue procedures in delaying eventual bony osteotomies, this study supports the use of femoral osteotomies alone or combined femoral and pelvic osteotomies over soft tissue procedures. This is the first systematic review to statistically pool quantitative results from previous studies on this topic. Botox vs soft tissue procedures could not be included due to insufficient comparative studies on this topic. This meta-analysis is limited by the observational nature and small sample sizes of the included studies, with their inherent risk of bias. It is possible that with larger and higher quality studies, the results and conclusions of this analysis may be altered.

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Measurement of rotational deformity: using a smartphone application is more accurate than conventional methods

Cited by 15 publications

References 11 publications

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up

Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up

Evaluation of the smartphone for measurement of femoral rotational deformity

Evaluating the use of an electronic inclinometer in correcting rotational disorders of the hip in children

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