A precise method for determining acetabular component anteversion after total hip arthroplasty
A precise method for determining acetabular component anteversion after total hip arthroplasty
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DOI：
10.1302/0301-620x.101b9.bjj-2019-0085.r1
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发表时间：
2019-09-01
影响因子：
4.6
通讯作者：
Wu, K.
中科院分区：
文献类型：
--
作者：
Murphy, M. P.;Killen, C. J.;Wu, K.
目的 已经描述了测量全髋关节置换术（THA）后髋臼假体前倾角的几种放射学方法。这些技术受到重复性低的限制，不如 CT 3D 重建准确，而且使用起来很麻烦。这些方法还部分依赖于对组件的模糊放射边界的识别。我们提出了两种新颖的方法，即面积法和正交法，其设计目的是最大限度地利用易于识别的点，同时保持相同的三角原理。材料和方法对 141 名接受过初次 THA 的患者的 160 个髋部进行平片 X 线照片的回顾性研究。我们将面积法和正交法与两种当前领先方法（分别是 Widmer 和 Lewinnek 的方法）的可靠性和准确性进行了比较。结果 160 个骨盆前后位片显示，所提出的面积法与 Widmer 和 Lewinnek 描述的方法在统计上存在差异（分别为 p < 0.001 和 p = 0.004）。他们给出了最高的观察者间和观察者内部可靠性（分别为 0.992 和 0.998），并且完成时间较短（27.50 秒（SD 3.19）；p < 0.001）。此外，21 个可用的 CT 3D 重建显示，Area 方法实现了最高的 Pearson 相关系数（r = 0.956；p < 0.001）和与 CT 的最小统计差异（p = 0.704），在 1 度至 30 度测量的放射学前倾角范围内，CT-3D 重建的平均值在 1 度以内。结论我们的结果支持所提出的 Area 方法是 最可靠、最准确、最快速。他们不支持所提出的正交方法比 Widmer 或 Lewinnek 方法有任何统计优越性。
AimsSeveral radiological methods of measuring anteversion of the acetabular component after total hip arthroplasty (THA) have been described. These are limited by low reproducibility, are less accurate than CT 3D reconstruction, and are cumbersome to use. These methods also partly rely on the identification of obscured radiological borders of the component. We propose two novel methods, the Area and Orthogonal methods, which have been designed to maximize use of readily identifiable points while maintaining the same trigonometric principles.Materials and MethodsA retrospective study of plain radiographs was conducted on 160 hips of 141 patients who had undergone primary THA. We compared the reliability and accuracy of the Area and Orthogonal methods with two of the current leading methods: those of Widmer and Lewinnek, respectively.ResultsThe 160 anteroposterior pelvis films revealed that the proposed Area method was statistically different from those described by Widmer and Lewinnek (p < 0.001 and p = 0.004, respectively). They gave the highest inter- and intraobserver reliability (0.992 and 0.998, respectively), and took less time (27.50 seconds (SD 3.19); p < 0.001) to complete. In addition, 21 available CT 3D reconstructions revealed the Area method achieved the highest Pearson's correlation coefficient (r = 0.956; p < 0.001) and least statistical difference (p = 0.704) from CT with a mean within 1 degrees of CT-3D reconstruction between ranges of 1 degrees to 30 degrees of measured radiological anteversion.ConclusionOur results support the proposed Area method to be the most reliable, accurate, and speedy. They did not support any statistical superiority of the proposed Orthogonal method to that of the Widmer or Lewinnek method.