The best method for evaluating anteversion of the acetabular component after total hip arthroplasty on plain radiographs

• Published in: Journal of orthopaedic surgery and research 2018-04, Vol.13 (1), p.66-66, Article 66
• Main Authors: Park, Yang Soo, Shin, Won Chul, Lee, Sang Min, Kwak, Sang Ho, Bae, Jung Yun, Suh, Kuen Tak
• Format: Article
• Language: English
• Subjects: Acetabular component; Acetabulum - diagnostic imaging; Acetabulum - pathology; Adult; Aged; Anteversion; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - instrumentation; Arthroplasty, Replacement, Hip - methods; Bone Anteversion - diagnostic imaging; Bone Anteversion - etiology; Bone Anteversion - pathology; CAT scans; Female; Hip Prosthesis; Hip replacement arthroplasty; Humans; Male; Middle Aged; Observer Variation; Plain radiograph; Radiographic Image Interpretation, Computer-Assisted - methods; Radiography; Reproducibility of Results; Total hip arthroplasty; Young Adult
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-018-0767-4

Several radiological methods for measuring the anteversion of the acetabular component after total hip arthroplasty (THA) exist, and no single standardized method has been established. We evaluated the reliability and accuracy of six widely utilized methods (Liaw et al., Lewinnek et al., Widmer, Hassan et al., Ackland et al., and Woo and Morrey) for measuring anteversion on plain radiographs, using a reference standard in the same definition obtained from the PolyWare programme. We reviewed 71 patients who underwent primary unilateral THA. The anteversion of the acetabular component was measured on pelvis AP radiographs using five different methods (Liaw et al., Lewinnek et al., Widmer, Hassan et al., and Ackland et al.) and on cross-table lateral radiographs using the method of Woo and Morrey. The values obtained using the PolyWare programme, which determines the anteversion of the acetabular component by edge detection, were regarded as the reference standard. Intra- and inter-observer reliabilities were excellent for all methods using plain radiographs, including the PolyWare programme. The method of Liaw et al. obtained values similar to those obtained using the PolyWare programme and was thus considered accurate (P = 0.447). However, values obtained using the other five methods significantly differed from those obtained using the PolyWare programme and were thus considered less accurate (P