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Misinterpretation of cup anteversion in total hip arthroplasty using planar radiography

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Anteroposterior pelvic radiographs are routinely used to monitor cup orientation in total hip arthroplasty (THA). Analysis of planar radiographs leads to a certain degree of measurement error for the cup anteversion (AV). With the current study, we wanted to clarify whether planar radiography can be used for accurate evaluation of the THA position.

Materials and methods

The postoperative orientation of pelvic implants in 42 patients was analyzed according to five documented mathematical algorithms using planar radiographs. Postoperative computed tomography (CT) pelvis scans were available for all patients. A CT-based navigation system was used to determine AV.

Results

The comparison showed that all five formulas presented substantial variations for the AV angle. Of these, Widmer’s algorithm presented the smallest difference compared to the CT. Misinterpretation of postoperative planar radiographs is a common problem in THA.

Conclusion

Planar radiographs are too imprecise for exact evaluation of the correct cup AV after THA. CT-based analysis may be necessary if exact values are required.

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Acknowledgment

We thank Mrs. K. Schreyer, as a native speaker, for critical reading of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany

    Axel Marx, Marius von Knoch, Jörg Pförtner & Guido Saxler

  2. Department of Orthopaedic Surgery, University of Bochum, Gudrunstraße 56, 44791, Bochum, Germany

    Matthias Wiese

Authors
  1. Axel Marx
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  2. Marius von Knoch
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  3. Jörg Pförtner
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  4. Matthias Wiese
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  5. Guido Saxler
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Correspondence to Axel Marx.

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Marx, A., von Knoch, M., Pförtner, J. et al. Misinterpretation of cup anteversion in total hip arthroplasty using planar radiography. Arch Orthop Trauma Surg 126, 487–492 (2006). https://doi.org/10.1007/s00402-006-0163-0

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  • DOI: https://doi.org/10.1007/s00402-006-0163-0

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