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

Jessica O. Leasure; Jeffrey N. Peck; Armando Villamil; Kara L. Fiore; Cheryl A. Tano

doi:10.3415/VCOT-16-05-0068

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

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

¹Affiliated Veterinary Specialists, Maitland, FL, USA

,

Jeffrey N. Peck

¹Affiliated Veterinary Specialists, Maitland, FL, USA

,

Armando Villamil

¹Affiliated Veterinary Specialists, Maitland, FL, USA

,

Kara L. Fiore

¹Affiliated Veterinary Specialists, Maitland, FL, USA

,

Cheryl A. Tano

¹Affiliated Veterinary Specialists, Maitland, FL, USA

› Institutsangaben

Abstract

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

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Referenzen

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.
2 Olmstead ML. Total hip replacement. Vet Clin North Am Small Anim Pract 1987; 17: 943-955.
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.
4 Allen MJ. Advances in total joint replacement in small animals. J Small Anim Pract 2012; 53: 495-506.
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.
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.
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.
8 Olmstead ML. The canine cemented modular total hip prosthesis. J Am Anim Hosp Assoc 1995; 31: 109-124.
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.
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.
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.
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.
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.
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.
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.
16 Dyce J, Wisner ER, Schrader SC. et al. Radiographic evaluation of acetabular component position in dogs. Vet Surg 2001; 30: 28-39.
17 Cross AR, Newell SM. Definition and determination of acetabular component orientation in cemented total hip arthroplasty. Vet Surg 2000; 29: 507-516.
18 Vezzoni A. Zürich Cementless Total Hip Replacement [Course Material]. KYON. Cremona, Italy 2014 [cited 2015 December 15] Available from: http://www.kyon.ch
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.
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.
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.
22 Cross AR, Newell SM. Definition and determination of acetabular component orientation in cemented total hip arthroplasty. Vet Surg 2000; 29: 507-516.
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.
24 Malik A, Wan Z, Jaramaz B. et al. A validation model for measurement of acetabular component position. J Arthroplasty 2010; 25: 812-819.
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.
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.
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.
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.
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.
31 Seradge H, Nagle KR, Miller RJ. Analysis of version in the acetabular cup. Clin Orthop Relat Res 1982; 166: 152-157.
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.
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.
34 Haaker RGA, Tiedjen K, Ottersbach A. et al. Comparison of conventional versus computer-navigated acetabular component insertion. J Arthroplasty 2007; 22: 151-159.
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.