Feasibility study on measuring anteversion angle of acetabular prosthesis after total hip arthroplasty using arbitrary point method_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Bowen ¹ , LI Longyuan ² ,  ZHANG Heng ¹

1. Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Key Laboratory of Tissue Transplantation, Bengbu Anhui, 233004, P. R. China;
2. Department of Neurosurgery, the First Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215008, P. R. China;

Corresponding author：

ZHANG Heng, Email: bygkzhangheng@163.com

Keywords：

Total hip arthroplasty; acetabular prosthesis; anteversion angle; X-ray film; CT

DOI：

10.7507/1002-1892.202501009

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the reliability and accuracy of the arbitrary point method for measuring the anteversion angle of acetabular prosthesis after total hip arthroplasty (THA) based on pelvic X-ray films. Methods The clinical data of 23 patients (25 hips) who underwent THA between December 2018 and September 2023 and met the selection criteria were retrospectively analyzed. Among them, there were 16 males and 7 females, with an average age of 57.6 years (range, 34-81 years); 13 hips had THA on the left side and 12 on the right side. There were 19 cases (21 hips) of osteonecrosis of the femoral head, 2 cases (2 hips) of femoral neck fractures, 1 case (1 hip) of developmental dysplasia of the hip, and 1 case (1 hip) of osteoarthritis. After THA, all patients underwent X-ray examination and CT scan. Three physicians measured the anteversion angle of acetabular prosthesis using the arbitrary point method and the CT measurement method respectively, and repeated the measurements three times. The results of the two measurement methods were compared, and the intraclass correlation coefficient (ICC) was employed to assess the reproducibility of the methods. Results The anteversion angles of acetabular prosthesis were (15.87±7.73)° measured by the arbitrary point method, and (15.31±7.89)° measured by CT measurement method. There was no significant difference between the two methods (t=1.515, P=0.143). The ICC of the measurement results by the arbitrary point method for the three physicians were 0.97 (P<0.001), 0.96 (P<0.001), and 0.96 (P<0.001), respectively; and the ICC of the measurement results by CT method were 0.93 (P<0.001), 0.93 (P<0.001), and 0.94 (P<0.001), respectively. Conclusion The arbitrary point method for measuring the anteversion angle of acetabular prosthesis after THA based on pelvic X-ray film is easy to operate, accurate, and has high reproducibility.

Citation： LI Bowen, LI Longyuan, ZHANG Heng. Feasibility study on measuring anteversion angle of acetabular prosthesis after total hip arthroplasty using arbitrary point method. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(4): 420-424. doi: 10.7507/1002-1892.202501009 Copy

1.	Sato EH, Stevenson KL, Blackburn BE, et al. Recovery curves for patient reported outcomes and physical function after total hip arthroplasty. J Arthroplasty, 2023, 38(7S): S65-S71.
2.	Anderson CG, Jang SJ, Brilliant ZR, et al. Complication rate after primary total hip arthroplasty using the posterior approach and enabling technology: A consecutive series of 2, 888 hips. J Arthroplasty, 2023, 38(7S): S119-S123.
3.	Salman LA, Hantouly AT, Khatkar H, et al. The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis. Int Orthop, 2023, 47(12): 3043-3052.
4.	Tang H, Li Y, Zhou Y, et al. A modeling study of a patient-specific safe zone for tha: calculation, validation, and key factors based on standing and sitting sagittal pelvic tilt. Clin Orthop Relat Res, 2022, 480(1): 191-205.
5.	Lao HD, Liu D, Cheng B, et al. Personalized digital simulation-assisted acetabular component implantation in revision hip arthroplasty. Exp Ther Med, 2024, 27(5): 180. doi: 10.3892/etm.2024.12468.
6.	Kainz H, Mindler GT, Kranzl A. Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking. PLoS One, 2023, 18(10): e0291458. doi: 10.1371/journal.pone.0291458.
7.	Tauriainen TJT, Niinimäki TT, Niinimäki JL, et al. Poor acetabular component orientation increases revision risk in metal-on-metal hip arthroplasty. J Arthroplasty, 2017, 32(7): 2204-2207.
8.	van Erp JHJ, Snijders TE, Weinans H, et al. The role of the femoral component orientation on dislocations in THA: a systematic review. Arch Orthop Trauma Surg, 2022, 142(6): 1253-1264.
9.	Grammatopoulos G, Falsetto A, Sanders E, et al. Integrating the combined sagittal index reduces the risk of dislocation following total hip replacement. J Bone Joint Surg (Am), 2022, 104(5): 397-411.
10.	Mao C, Liang Y, Ding C, et al. The consistency between measurements of the femoral neck anteversion angle in DDH on three-dimensional CT and MRI. Acta Radiol, 2016, 57(6): 716-720.
11.	Kaiser M, Renkawitz T, Benditz A, et al. Pelvic tilt impacts cup orientation on CT: how accurate is the gold standard? Acta Radiol, 2022, 63(5): 698-705.
12.	Lin CH, Chen WC, Weng PW, et al. Liaw’s ellipse anteversion method for distinguishing acetabular component retroversion from anteversion on plain radiographs. Orthopaedic Surgery, 2024, 16(1): 276-281.
13.	Lee GC, Lee SH, Kang SW, et al. Accuracy of planar anteversion measurements using anteroposterior radiographs. BMC Musculoskelet Disord, 2019, 20(1): 586. doi: 10.1186/s12891-019-2979-0.
14.	Yeh KL, Wu TY, Ma HH, et al. Ellipse method for measuring Liaw’s anteversion of the acetabular component after total hip arthroplasty. BMC Musculoskelet Disord, 2020, 21(1): 667. doi: 10.1186/s12891-020-03669-5.
15.	Bachhal V, Jindal N, Saini G, et al. A new method of measuring acetabular cup anteversion on simulated radiographs. Int Orthop, 2012, 36(9): 1813-1818.
16.	Snijders TE, Schlösser TPC, van Gaalen SM, et al. Non-equivalent results from different anteversion measurements methods for the evaluation of the acetabular cup orientation in total hip arthroplasty. Orthop Surg, 2019, 11(2): 241-247.
17.	Lu M, Zhou YX, Du H, Zhang J, Liu J. Reliability and validity of measuring acetabular component orientation by plain anteroposterior radiographs. Clin Orthop Relat Res, 2013, 471(9): 2987-2994.
18.	Xiao H, Zheng NY, Wang J, et al. A novel method of acetabular component anteversion measurement on plain radiographs. BMC Musculoskelet Disord, 2024, 25(1): 912. doi: 10.1186/s12891-024-08006-8.
19.	Henckel J, Ramesh A, Hothi H, et al. The accuracy and precision of acetabular implant measurements from CT imaging. Front Bioeng Biotechnol, 2023, 11: 1150061. doi: 10.3389/fbioe.2023.1150061.
20.	Bachhal V, Saini G, Jindal N, et al. GeoGebra: A reliable and free software for measuring acetabular cup anteversion on digitalized plain radiographs. J Clin Orthop Trauma, 2020, 11(Suppl 2): S201-S205.
21.	Guezou-Philippe A, Dardenne G, Letissier H, et al. Anterior pelvic plane estimation for total hip arthroplasty using a joint ultrasound and statistical shape model based approach. Med Biol Eng Comput, 2023, 61(1): 195-204.
22.	Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2): 228-232.
23.	Yang G, Li Y, Zhang H. The influence of pelvic tilt on the anteversion angle of the acetabular prosthesis. Orthop Surg, 2019, 11(5): 762-769.
24.	Zahn RK, Grotjohann S, Ramm H, et al. Pelvic tilt compensates for increased acetabular anteversion. Int Orthop, 2016, 40(8): 1571-1575.
25.	Wan Z, Malik A, Jaramaz B, et al. Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res, 2009, 467(1): 32-42.

1. Sato EH, Stevenson KL, Blackburn BE, et al. Recovery curves for patient reported outcomes and physical function after total hip arthroplasty. J Arthroplasty, 2023, 38(7S): S65-S71.
2. Anderson CG, Jang SJ, Brilliant ZR, et al. Complication rate after primary total hip arthroplasty using the posterior approach and enabling technology: A consecutive series of 2, 888 hips. J Arthroplasty, 2023, 38(7S): S119-S123.
3. Salman LA, Hantouly AT, Khatkar H, et al. The outcomes of total hip replacement in osteonecrosis versus osteoarthritis: a systematic review and meta-analysis. Int Orthop, 2023, 47(12): 3043-3052.
4. Tang H, Li Y, Zhou Y, et al. A modeling study of a patient-specific safe zone for tha: calculation, validation, and key factors based on standing and sitting sagittal pelvic tilt. Clin Orthop Relat Res, 2022, 480(1): 191-205.
5. Lao HD, Liu D, Cheng B, et al. Personalized digital simulation-assisted acetabular component implantation in revision hip arthroplasty. Exp Ther Med, 2024, 27(5): 180. doi: 10.3892/etm.2024.12468.
6. Kainz H, Mindler GT, Kranzl A. Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking. PLoS One, 2023, 18(10): e0291458. doi: 10.1371/journal.pone.0291458.
7. Tauriainen TJT, Niinimäki TT, Niinimäki JL, et al. Poor acetabular component orientation increases revision risk in metal-on-metal hip arthroplasty. J Arthroplasty, 2017, 32(7): 2204-2207.
8. van Erp JHJ, Snijders TE, Weinans H, et al. The role of the femoral component orientation on dislocations in THA: a systematic review. Arch Orthop Trauma Surg, 2022, 142(6): 1253-1264.
9. Grammatopoulos G, Falsetto A, Sanders E, et al. Integrating the combined sagittal index reduces the risk of dislocation following total hip replacement. J Bone Joint Surg (Am), 2022, 104(5): 397-411.
10. Mao C, Liang Y, Ding C, et al. The consistency between measurements of the femoral neck anteversion angle in DDH on three-dimensional CT and MRI. Acta Radiol, 2016, 57(6): 716-720.
11. Kaiser M, Renkawitz T, Benditz A, et al. Pelvic tilt impacts cup orientation on CT: how accurate is the gold standard? Acta Radiol, 2022, 63(5): 698-705.
12. Lin CH, Chen WC, Weng PW, et al. Liaw’s ellipse anteversion method for distinguishing acetabular component retroversion from anteversion on plain radiographs. Orthopaedic Surgery, 2024, 16(1): 276-281.
13. Lee GC, Lee SH, Kang SW, et al. Accuracy of planar anteversion measurements using anteroposterior radiographs. BMC Musculoskelet Disord, 2019, 20(1): 586. doi: 10.1186/s12891-019-2979-0.
14. Yeh KL, Wu TY, Ma HH, et al. Ellipse method for measuring Liaw’s anteversion of the acetabular component after total hip arthroplasty. BMC Musculoskelet Disord, 2020, 21(1): 667. doi: 10.1186/s12891-020-03669-5.
15. Bachhal V, Jindal N, Saini G, et al. A new method of measuring acetabular cup anteversion on simulated radiographs. Int Orthop, 2012, 36(9): 1813-1818.
16. Snijders TE, Schlösser TPC, van Gaalen SM, et al. Non-equivalent results from different anteversion measurements methods for the evaluation of the acetabular cup orientation in total hip arthroplasty. Orthop Surg, 2019, 11(2): 241-247.
17. Lu M, Zhou YX, Du H, Zhang J, Liu J. Reliability and validity of measuring acetabular component orientation by plain anteroposterior radiographs. Clin Orthop Relat Res, 2013, 471(9): 2987-2994.
18. Xiao H, Zheng NY, Wang J, et al. A novel method of acetabular component anteversion measurement on plain radiographs. BMC Musculoskelet Disord, 2024, 25(1): 912. doi: 10.1186/s12891-024-08006-8.
19. Henckel J, Ramesh A, Hothi H, et al. The accuracy and precision of acetabular implant measurements from CT imaging. Front Bioeng Biotechnol, 2023, 11: 1150061. doi: 10.3389/fbioe.2023.1150061.
20. Bachhal V, Saini G, Jindal N, et al. GeoGebra: A reliable and free software for measuring acetabular cup anteversion on digitalized plain radiographs. J Clin Orthop Trauma, 2020, 11(Suppl 2): S201-S205.
21. Guezou-Philippe A, Dardenne G, Letissier H, et al. Anterior pelvic plane estimation for total hip arthroplasty using a joint ultrasound and statistical shape model based approach. Med Biol Eng Comput, 2023, 61(1): 195-204.
22. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2): 228-232.
23. Yang G, Li Y, Zhang H. The influence of pelvic tilt on the anteversion angle of the acetabular prosthesis. Orthop Surg, 2019, 11(5): 762-769.
24. Zahn RK, Grotjohann S, Ramm H, et al. Pelvic tilt compensates for increased acetabular anteversion. Int Orthop, 2016, 40(8): 1571-1575.
25. Wan Z, Malik A, Jaramaz B, et al. Imaging and navigation measurement of acetabular component position in THA. Clin Orthop Relat Res, 2009, 467(1): 32-42.

Chinese Journal of Reparative and Reconstructive Surgery

Feasibility study on measuring anteversion angle of acetabular prosthesis after total hip arthroplasty using arbitrary point method

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content