Measurement of Acetabular Component Position in Total Hip Arthroplasty in Dogs: Comparison of a Radio-Opaque Cup Position Assessment Device Using Fluoroscopy with CT Assessment and Direct MeasurementFunding The study was funded by the Tufts Orthopedic Research Laboratory and Arizona Canine Orthopedics & Sports Medicine.
Objectives The aim of this study was to compare measurements of angle of lateral opening (ALO) and version determined using a radioopaque cup position assessment device imaged with fluoroscopy to measurements obtained by CT and direct measurement in a cadaveric model. Our null hypothesis was that there would not be any difference in the angles measured by the techniques.
Methods Six cadavers were implanted with BFX acetabular components. The CPAD was placed and images were obtained with fluoroscopy. Measurements were obtained from the radiopaque marker bars on the CPAD device, and version and ALO were calculated. The ALO and version were determined by CT and DM. Comparisons were made using a two-way analysis of variance and a generalized linear model procedure analysis.
Results There were no significant differences between the measurements for ALO (p = 0.275) or version (p = 0.226). Correlation between methods was 0.948 and 0.951 for ALO and version, respectively. The mean difference (standard deviation [SD], and 95% confidence interval [CI]) for ALO were: CT versus CPAD 1.85 degrees (± 2.32 degrees [-2.99–3.31]), CT versus DM 1.96 degrees (± 1.99 degrees [−2.2–4.27]), CPAD versus DM1.74 degrees (±2.21 degrees [−1.13 and 5.24]). The mean difference (SD [CI]) for version was CT versus CPAD 2.86 degrees (±1.56 degrees [ −2.63–1.69]), CT versus DM 1.10 degrees (±1.42 degrees [−1.57–2.09]), CPAD versus DM 1.07 degrees (±0.76 degrees [0.13–2.09]).
Clinical Relevance The results demonstrate that intraoperative imaging in cadaveric specimens with the CPAD is an accurate method to determine ALO and version of the acetabular component.
Keywordstotal hip arthroplasty - acetabular component - angle of lateral opening - cup position assessment device - canine cadaver
R. Lirtzman contributed to the concept and design of the Cup Positioning Assessment Device. All authors contributed to the study design. B Dalbeth, W. M. Karlin and R. Lirtzman contributed to the data acquisition. B Dalbeth, W. M. Karlin and M. Kowaleski contributed to analysis and interpretation of data. All authors drafted and revised the manuscript and approved submission.
This study was presented in part at the ACVS Surgery Summit in Phoenix, Arizona, 25 October 2018.
Eingereicht: 04. November 2019
Angenommen: 20. Mai 2020
24. August 2020 (online)
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Stuttgart · New York
- 1 Bergh MS, Budsberg SC. A systematic review of the literature describing the efficacy of surgical treatments for canine hip dysplasia (1948-2012). Vet Surg 2014; 43 (05) 501-506
- 2 DeYoung DJ, DeYoung BA, Aberman HA, Kenna RV, Hungerford DS. Implantation of an uncemented total hip prosthesis. Technique and initial results of 100 arthroplasties. Vet Surg 1992; 21 (03) 168-177
- 3 Edwards MR, Egger EL, Schwarz PD. Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991-1995). J Am Vet Med Assoc 1997; 211 (05) 580-586
- 4 Guerrero TG, Montavon PM. Zurich cementless total hip replacement: retrospective evaluation of 2nd generation implants in 60 dogs. Vet Surg 2009; 38 (01) 70-80
- 5 Olmstead ML. The canine cemented modular total hip prosthesis. J Am Anim Hosp Assoc 1995; 31 (02) 109-124
- 6 Bergh MS, Gilley RS, Shofer FS, Kapatkin AS. Complications and radiographic findings following cemented total hip replacement: a retrospective evaluation of 97 dogs. Vet Comp Orthop Traumatol 2006; 19 (03) 172-179
- 7 Budsberg SC, Chambers JN, Lue SL, Foutz TL, Reece L. Prospective evaluation of ground reaction forces in dogs undergoing unilateral total hip replacement. Am J Vet Res 1996; 57 (12) 1781-1785
- 8 Massat BJ, Vasseur PB. Clinical and radiographic results of total hip arthroplasty in dogs: 96 cases (1986-1992). J Am Vet Med Assoc 1994; 205 (03) 448-454
- 9 Hunter S, Dyce J, Butkus L, Olmstead M. Acetabular cup displacement after polyethlyene-cement interface failure: a complication of total hip replacement in seven dogs. Vet Comp Orthop Traumatol 2003; 16: 99-104
- 10 Torres BT, Budsberg SC. Revision of cemented total hip arthroplasty with cementless components in three dogs. Vet Surg 2009; 38 (01) 81-86
- 11 Conzemius MG, Vandervoort J. Total joint replacement in the dog. Vet Clin North Am Small Anim Pract 2005; 35 (05) 1213-1231 , vii
- 12 Liska WD, Israel SK, Poteet BA. Polar gap after cementless total hip replacement in dogs. Vet Surg 2019; 48 (03) 321-335
- 13 Dyce J, Wisner ER, Wang Q, Olmstead ML. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg 2000; 29 (06) 524-532
- 14 Nelson LL, Dyce J, Shott S. Risk factors for ventral luxation in canine total hip replacement. Vet Surg 2007; 36 (07) 644-653
- 15 Peck JN, Marcellin-Little DJ. Advances in small animal joint replacement. 1st edition. Ames: John Wiley & Sons, Inc.; 2013
- 16 Milone M, Vigdorchik J, Schwarzkopf R, Jerabek SA. Patient positioning is not reliable in total hip arthroplasty. . Presented at: The International Society for Technology in Arthroplasty 29th Annual Congress; Oct 5–8, 2016; Boston, MA
- 17 Renwick A, Gemmill T, Pink J, Brodbelt D, McKee M. Radiographic evaluation of BFX acetabular component position in dogs. Vet Surg 2011; 40 (05) 610-620
- 18 Dyce J, Wisner ER, Schrader SC, Wang Q, Olmstead ML. Radiographic evaluation of acetabular component position in dogs. Vet Surg 2001; 30 (01) 28-39
- 19 Johnson KA. Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th ed. Philadelphia, PA: Saunders; 2014
- 20 BioMedtrix universal canine hip system. Surgical technique for BFX cementless and CFX cemented implants, BioMedtrix, Boonton, New Jersey. Released August 28, 2007
- 21 Leasure JO, Peck JN, Villamil A, Fiore KL, Tano CA. Inter- and intra-observer variability of radiography and computed tomography for evaluation of Zurich cementless acetabular cup placement ex vivo. Vet Comp Orthop Traumatol 2016; 29 (06) 507-514
- 22 Aman AM, Wendelburg KL. Assessment of acetabular cup positioning from a lateral radiographic projection after total hip replacement. Vet Surg 2013; 42 (04) 406-417
- 23 Baxter JA, Barlow T, Karthikeyan S, Mayo DJ, King RJ. The accuracy of automatic calibration of digital pelvic radiographs using two different scale markers: a comparative study. Hip Int 2012; 22 (01) 82-89
- 24 Franken M, Grimm B, Heyligers I. A comparison of four systems for calibration when templating for total hip replacement with digital radiography. J Bone Joint Surg Br 2010; 92 (01) 136-141
- 25 Conn KS, Clarke MT, Hallett JP. A simple guide to determine the magnification of radiographs and to improve the accuracy of preoperative templating. J Bone Joint Surg Br 2002; 84 (02) 269-272
- 26 Hummel DW, Lanz OI, Werre SR. Complications of cementless total hip replacement. A retrospective study of 163 cases. Vet Comp Orthop Traumatol 2010; 23 (06) 424-432
- 27 Gemmill TJ, Pink J, Renwick A. , et al. Hybrid cemented/cementless total hip replacement in dogs: seventy-eight consecutive joint replacements. Vet Surg 2011; 40 (05) 621-630
- 28 Cross AR, Newell SM, Chambers JN, Shultz KB, Kubilis PS. Acetabular component orientation as an indicator of implant luxation in cemented total hip arthroplasty. Vet Surg 2000; 29 (06) 517-523
- 29 Hayes GM, Ramirez J, Langley Hobbs SJ. Use of the cumulative summation technique to quantitatively assess a surgical learning curve: canine total hip replacement. Vet Surg 2011; 40 (01) 1-5