Positioning of the acetabular component in cemented prostheses - radiographic calculation

Labronici, Pedro José; Motta, Ramon Louro; Esteves, Bruno Bandeira; Franco, José Sergio; Hoffmann, Rolix; Ferreira, Luiz Aurélio Costa; Giordano, Marcos; Alves, Sergio Delmonte

doi:10.1016/j.rboe.2012.04.001

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Revista Brasileira de Ortopedia

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Original Article • Rev. bras. ortop. 48 (1) • Jan-Feb 2013 • https://doi.org/10.1016/j.rboe.2012.04.001 copy

Positioning of the acetabular component in cemented prostheses - radiographic calculation

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to assess the reliability of the inclination angle and anteversion of acetabular cup component in patients with idiopatic osteoarthritis of the hip, aseptic necrosis and hip neck fracture using trigonometric formula and plain radiographs.

METHODS:

66 patients underwent cemented total arthroplasty of 72 hips. The inclination of acetabular component was measured using plain radiograph. The acetabular component anteversion was measured using trigonometric formula.

RESULTS:

it was observed that, in the osteoarthritic hips, hip neck fracture and aseptic necrosis, the degree of agreement was highly significant (p < 0.0001), in the measurements of anteversion and inclination angles, among the three assessments, from intra as well as inter-observers. All the agreement pairs were of excellent degree (ICC > 0.80).

CONCLUSION:

using plain radiographs and trigonometric formula, the method resulted to be highly accurate and reliable. Besides being easy to be calculated. No significant variation was found in the anteversion and inclination angles when compared with osteoarthritis of the hip, aseptic necrosis and hip neck fracture.

Mycobacteria, atypical; Keratitis; Corneal transplantation

Variable	Category	n	%
Age (years)	67.1 ± 14.2 (30 - 91)
Etiology	Arthrosis	48	66.7
	Hip fracture	16	22.2
	Aseptic necrosis	8	11.1
Side	Right	38	52.8
	Left	34	47.2

Observer	Measurement	Mean ± SD			Minimum	Maximum
Observer 1	AA 1	13.2	±	7.4	0	34.9
Observer 1	AA 2	13.0	±	7.4	2.7	32.6
Observer 2	AA 1	13.2	±	7.5	0	33.3
Observer 2	AA 2	12.2	±	7.0	0	29.2
Observer 3	AA 1	14.2	±	7.4	2.6	31.9
Observer 3		11.4	±	6.6	0	30.0

Observer	Measurement	Mean ± SD			Minimum	Maximum
Observer 1	AI 1	42.6	±	9.0	22	64
Observer 1	AI 2	42.8	±	9.1	24	62
Observer 2	AI 1	42.6	±	8.6	24	62
Observer 2	AI 2	43.8	±	8.2	24	64
Observer 3	AI 1	42.5	±	8.8	22	64
Observer 3	AI 2	42.3	±	8.7	22	60

Measurement	Analysis	Observers	ICC	95% CI		p value
Anteversion angle (AA)
	Intra-observer	Obs1 x Obs1	0.951	0.92 -	0.97	< 0.0001
		Obs2 x Obs2	0.842	0.76 -	0.90	< 0.0001
		Obs3 x Obs3	0.860	0.79 -	0.91	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.932	0.89 -	0.96	< 0.0001
		Obs1 x Obs3	0.944	0.91 -	0.97	< 0.0001
		Obs2 x Obs3	0.917	0.87 -	0.95	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.901	0.85 -	0.94	< 0.0001
		Obs1 x Obs3	0.919	0.88 -	0.95	< 0.0001
			0.900	0.85 -	0.94	< 0.0001
Inclination angle (AI)
	Intra-observer	Obs1 x Obs1	0.956	0.93 -	0.97	< 0.0001
		Obs2 x Obs2	0.917	0.87 -	0.95	< 0.0001
		Obs3 x Obs3	0.942	0.91 -	0.96	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.942	0.91 -	0.96	< 0.0001
		Obs1 x Obs3	0.958	0.93 -	0.97	< 0.0001
		Obs2 x Obs3	0.936	0.90 -	0.96	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.921	0.88 -	0.95	< 0.0001
		Obs1 x Obs3	0.946	0.92 -	0.97	< 0.0001
			0.911	0.86 -	0.94	< 0.0001

Measurement	Analysis	Observers	ICC	95% CI		p value
Anteversion angle (AA)
	Intra-observer	Obs1 x Obs1	0.963	0.94 -	0.98	< 0.0001
		Obs2 x Obs2	0.864	0.77 -	0.92	< 0.0001
		Obs3 x Obs3	0.860	0.76 -	0.92	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.934	0.89 -	0.96	< 0.0001
		Obs1 x Obs3	0.946	0.91 -	0.97	< 0.0001
		Obs2 x Obs3	0.923	0.87 -	0.96	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.902	0.83 -	0.94	< 0.0001
		Obs1 x Obs3	0.918	0.86 -	0.95	< 0.0001
			0.897	0.82 -	0.94	< 0.0001
Inclination angle (AI)
	Intra-observer	Obs1 x Obs1	0.946	0.91 -	0.97	< 0.0001
		Obs2 x Obs2	0.900	0.83 -	0.94	< 0.0001
		Obs3 x Obs3	0.940	0.90 -	0.97	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.929	0.88 -	0.96	< 0.0001
		Obs1 x Obs3	0.945	0.90 -	0.97	< 0.0001
		Obs2 x Obs3	0.928	0.88 -	0.96	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.909	0.84 -	0.95	< 0.0001
		Obs1 x Obs3	0.937	0.89 -	0.96	< 0.0001
			0.898	0.83 -	0.94	< 0.0001

Measurement	Analysis	Observers	ICC	95% CI		p value
Anteversion angle (AA)
	Intra-observer	Obs1 x Obs1	0.903	0.75 -	0.97	< 0.0001
		Obs2 x Obs2	0.709	0.36 -	0.89	0.001
		Obs3 x Obs3	0.837	0.60 -	0.94	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.915	0.78 -	0.97	< 0.0001
		Obs1 x Obs3	0.930	0.82 -	0.98	< 0.0001
		Obs2 x Obs3	0.863	0.66 -	0.95	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.848	0.63 -	0.94	< 0.0001
		Obs1 x Obs3	0.902	0.75 -	0.96	< 0.0001
			0.882	0.70 -	0.96	< 0.0001
Inclination angle (AI)
	Intra-observer	Obs1 x Obs1	0.957	0.88 -	0.99	< 0.0001
		Obs2 x Obs2	0.943	0.85 -	0.98	< 0.0001
		Obs3 x Obs3	0.946	0.86 -	0.98	< 0.0001
	Inter-observer (measurement 1)	Obs1 x Obs2	0.957	0.89 -	0.99	< 0.0001
		Obs1 x Obs3	0.981	0.95 -	0.99	< 0.0001
		Obs2 x Obs3	0.934	0.83 -	0.98	< 0.0001
	Inter-observer (measurement 2)	Obs1 x Obs2	0.935	0.83 -	0.98	< 0.0001
		Obs1 x Obs3	0.969	0.92 -	0.99	< 0.0001
			0.942	0.85 -	0.98	< 0.0001

Etiology	n	Mean ± SD			Median	p value ^a
Arthrosis	48	13.9	±	7.5	12.9	0.12
Fracture	16	11.7	±	5.5	11.2
Necrosis	8	8.8	±	4.6	9.0
Total	72	12.9	±	7.0	12.0

Etiology	n	Mean ± SD			Median	p value ^a
Arthrosis	48	44,1	±	8,5	43,9	0,16
Fracture	16	40,0	±	7,6	39,8
Necrosis	8	40,2	±	9,4	38,4
Total	72	42,8	±	8,5	41,8

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