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Vet Comp Orthop Traumatol 2016; 29(06): 507-514
DOI: 10.3415/VCOT-16-05-0068
Original Research
Schattauer GmbH

Inter- and intra-observer variability of radiography and computed tomography for evaluation of Zurich cementless acetabular cup placement ex vivo

Jessica O. Leasure
1   Affiliated Veterinary Specialists, Maitland, FL, USA
,
Jeffrey N. Peck
1   Affiliated Veterinary Specialists, Maitland, FL, USA
,
Armando Villamil
1   Affiliated Veterinary Specialists, Maitland, FL, USA
,
Kara L. Fiore
1   Affiliated Veterinary Specialists, Maitland, FL, USA
,
Cheryl A. Tano
1   Affiliated Veterinary Specialists, Maitland, FL, USA
› Author Affiliations
Further Information

Publication History

Received: 10 May 2016

Accepted: 26 July 2016

Publication Date:
19 December 2017 (online)

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Summary

Objective: To evaluate the inter- and intra-observer variability in measurement of the angle of lateral opening (ALO) and version angle measurement using digital radiography and computed tomography (CT).

Methods: Each hemipelvis was implanted with a cementless acetabular cup. Ventrodorsal and mediolateral radiographs were made of each pelvis, followed by CT imaging. After removal of the first cup, the pelves were implanted with an acetabular cup in the contra-lateral acetabulum and imaging was repeated. Three surgeons measured the ALO and version angles three times for each cup from the mediolateral radiographic projection. The same measurements were made using three-dimensional multiplanar reconstructions from CT images. Two anatomical axes were used to measure pelvic inclination in the sagittal plane, resulting in six measurements per cup. Two-way repeated measures analysis of variance evaluated inter- and intra-observer repeatability for radiographic and CT-based measurements.

Results: Version angle based on radio-graphic measurement did not differ within surgeons (p = 0.433), but differed between surgeons (p <0.001). Radiographic measurement of ALO differed within surgeons (p = 0.006) but not between surgeons (p = 0.989). The ALO and version angle measured on CT images did not differ with or between surgeons.

Clinical significance: Assessment of inter-and intra-observer measurement of ALO and version angle was more reproducible using CT images than conventional mediolateral radiography for a Zurich cementless acetabular cup.

Keywords

Canine - hip dysplasia - radiography - total hip arthroplasty - computed tomography
 

  • References

  • 1 Olmstead ML, Hohn RB, Turner TM. A five-year study of 221 total hip replacements in the dog. J Am Vet Med Assoc 1983; 183: 191-194.
    PubMedGoogle Scholar
  • 2 Olmstead ML. Total hip replacement. Vet Clin North Am Small Anim Pract 1987; 17: 943-955.
    CrossrefPubMedGoogle Scholar
  • 3 Marcellin-Little DJ, DeYoung BA, Doyens DH. et al. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a long-term prospective evaluation of 50 consecutive cases. Vet Surg 1999; 28: 10-20.
    CrossrefPubMedGoogle Scholar
  • 4 Allen MJ. Advances in total joint replacement in small animals. J Small Anim Pract 2012; 53: 495-506.
    CrossrefPubMedGoogle Scholar
  • 5 Dyce J, Wisner ER, Wang Q. et al. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg 2000; 29: 524-532.
    CrossrefPubMedGoogle Scholar
  • 6 DeYoung DJ, DeYoung BA, Aberman HA. et al. Implantation of an uncemented total hip prosthesis. Technique and initial results of 100 arthroplasties. Vet Surg 1992; 21: 168-177.
    CrossrefPubMedGoogle Scholar
  • 7 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: 448-454.
    PubMedGoogle Scholar
  • 8 Olmstead ML. The canine cemented modular total hip prosthesis. J Am Anim Hosp Assoc 1995; 31: 109-124.
    CrossrefPubMedGoogle Scholar
  • 9 Hanson SP, Peck JN, Berry CR. et al. Radiographic evaluation of the Zurich cementless total hip acetabular component. Vet Surg 2006; 35: 550-558.
    CrossrefPubMedGoogle Scholar
  • 10 Guerrero TG, Montavon PM. Zurich cementless total hip replacement: retrospective evaluation of 2nd generation implants in 60 dogs. Vet Surg 2009; 38: 70-80.
    CrossrefPubMedGoogle Scholar
  • 11 Vezzoni L, Vezzoni A, Boudrieau RJ. Long-term outcome of Zürich cementless total hip arthroplasty in 439 Cases. Vet Surg 2015; 44: 921-929.
    CrossrefPubMedGoogle Scholar
  • 12 DeSandre-Robinson DM, Kim SE, Peck JN. et al. Effect of dorsal acetabular rim loss on stability of the Zurich cementless total hip acetabular cup in dogs. Vet Surg 2014; 44: 195-199.
    PubMedGoogle Scholar
  • 13 Kowaleski MP. Biomechanical considerations in total hip replacement. In Marcellin-Little DJ, Peck JN. editors Advances in Small Animal Total Joint Replacement Ames, IA: Wiley-Blackwell; 2013: 53-68.
    Google Scholar
  • 14 Peck JN, Liska WD, DeYoung DJ. et al. Clinical application of total hip replacement. In Marcellin-Little DJ, Peck JN. editors Advances in Small Animal Total Joint Replacement Ames, IA: Wiley-Blackwell; 2013: 69-108.
    Google Scholar
  • 15 Peck JN, Marcellin-Little DJ. Revision strategies for total hip replacement. In Marcellin-Little DJ, Peck JN. editors Advances in Small Animal Total Joint Replacement Ames, IA: Wiley-Blackwell; 2013: 1-22.
    Google Scholar
  • 16 Dyce J, Wisner ER, Schrader SC. et al. Radiographic evaluation of acetabular component position in dogs. Vet Surg 2001; 30: 28-39.
    CrossrefPubMedGoogle Scholar
  • 17 Cross AR, Newell SM. Definition and determination of acetabular component orientation in cemented total hip arthroplasty. Vet Surg 2000; 29: 507-516.
    CrossrefPubMedGoogle Scholar
  • 18 Vezzoni A. Zürich Cementless Total Hip Replacement [Course Material]. KYON. Cremona, Italy 2014 [cited 2015 December 15] Available from: http://www.kyon.ch
    PubMedGoogle Scholar
  • 19 Aman AM, Wendelburg KL. Assessment of acetabular cup positioning from a lateral radiographic projection after total hip replacement. Vet Surg 2013; 42: 406-417.
    CrossrefPubMedGoogle Scholar
  • 20 Kalteis T, Handel M, Herold T. et al. Position of the acetabular cup -- accuracy of radiographic calculation compared to CT-based measurement. Eur J Radiol 2006; 58: 294-300.
    CrossrefPubMedGoogle Scholar
  • 21 Ghelman B, Kepler CK, Lyman S. et al. CT outperforms radiography for determination of acetabular cup version after total hip arthroplasty. Clin Orthop Relat Res 2009; 467: 2362-2370.
    CrossrefPubMedGoogle Scholar
  • 22 Cross AR, Newell SM. Definition and determination of acetabular component orientation in cemented total hip arthroplasty. Vet Surg 2000; 29: 507-516.
    CrossrefPubMedGoogle Scholar
  • 23 Lass R, Kubista B, Olischar B. et al. Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study. J Arthroplasty 2014; 29: 786-791.
    CrossrefPubMedGoogle Scholar
  • 24 Malik A, Wan Z, Jaramaz B. et al. A validation model for measurement of acetabular component position. J Arthroplasty 2010; 25: 812-819.
    CrossrefPubMedGoogle Scholar
  • 25 Kumar MA, Shetty MS, Kiran KG. et al. Validation of navigation assisted cup placement in total hip arthroplasty. Int Orthop 2012; 36: 17-22.
    CrossrefPubMedGoogle Scholar
  • 26 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: 1-5.
    CrossrefPubMedGoogle Scholar
  • 27 Peck JN, Marcellin-Little DJ. Advances in Small Animal Total Joint Replacement. Ames, IA: Wiley-Blackwell; 2013: 251
  • 28 Widmer KH. A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty 2004; 19: 387-390.
    CrossrefPubMedGoogle Scholar
  • 29 Visser JD, Konings JG. A new method for measuring angles after total hip arthroplasty. A study of the acetabular cup and femoral component. J Bone Joint Surg Br 1981; 63B: 556-559.
    CrossrefPubMedGoogle Scholar
  • 30 Paterno SA, Lachiewicz PF, Kelley SS. The influence of patient-related factors and the position of the acetabular component on the rate of dislocation after total hip replacement. J Bone Joint Surg Am 1997; 79: 1202-1210.
    CrossrefPubMedGoogle Scholar
  • 31 Seradge H, Nagle KR, Miller RJ. Analysis of version in the acetabular cup. Clin Orthop Relat Res 1982; 166: 152-157.
    PubMedGoogle Scholar
  • 32 Dorr LD, Malik A, Wan Z. et al. Precision and bias of imageless computer navigation and surgeon estimates for acetabular component position. Clin Orthop Relat Res 2007; 465: 92-99.
    PubMedGoogle Scholar
  • 33 Nogler M, Kessler O, Prassl A. et al. Reduced variability of acetabular cup positioning with use of an imageless navigation system. Clin Orthop Relat Res 2004; 426: 159-163.
    CrossrefPubMedGoogle Scholar
  • 34 Haaker RGA, Tiedjen K, Ottersbach A. et al. Comparison of conventional versus computer-navigated acetabular component insertion. J Arthroplasty 2007; 22: 151-159.
    PubMedGoogle Scholar
  • 35 Marx A, Knoch von M, Pförtner J. et al. Misinterpretation of cup anteversion in total hip arthroplasty using planar radiography. Arch Orthop Trauma Surg 2006; 126: 487-492.
    CrossrefPubMedGoogle Scholar