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Effect of Patient Positioning on Measurement of the Anterior Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to the Acetabular Rim
BACKGROUND: The anterior center-edge angle (ACEA) is used to quantify anterior coverage of the femoral head by the acetabulum. However, its measurement has not been evaluated in a manner consistent with routine use, and the precise 3-dimensional (3D) anatomic location where it measures coverage is n...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819774/ https://www.ncbi.nlm.nih.gov/pubmed/35141341 http://dx.doi.org/10.1177/23259671211073834 |
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author | Mozingo, Joseph D. Schuring, Lindsay L. Mortensen, Alexander J. Anderson, Andrew E. Aoki, Stephen K. |
author_facet | Mozingo, Joseph D. Schuring, Lindsay L. Mortensen, Alexander J. Anderson, Andrew E. Aoki, Stephen K. |
author_sort | Mozingo, Joseph D. |
collection | PubMed |
description | BACKGROUND: The anterior center-edge angle (ACEA) is used to quantify anterior coverage of the femoral head by the acetabulum. However, its measurement has not been evaluated in a manner consistent with routine use, and the precise 3-dimensional (3D) anatomic location where it measures coverage is not known. PURPOSE: To determine the effect of patient positioning on ACEA measurement reliability, magnitude, and 3D location. STUDY DESIGN: Descriptive laboratory study. METHODS: Included were 18 adults; 7 participants had cam morphology and femoroacetabular impingement syndrome, and 11 participants had no radiographic evidence of hip abnormalities and no history of hip pain or injuries. Ultimately, 3D femur and pelvis models were generated from computed tomography images. Radiographs were generated with the models in different degrees of pelvic rotation, tilt, and obliquity relative to the standard false-profile view. The ACEA was measured by 2 raters by selecting the location of the bone edge on each radiograph. Selections were projected onto the pelvis model and expressed as a clockface location on the acetabular rim. The clockface was mirrored on left hips to allow a direct comparison of locations between hips. Interrater and intrarater reliability were quantified via the intraclass correlation coefficient (ICC). The effect of position on ACEA measurements and clockface locations was determined via linear regression. RESULTS: Intrarater and interrater reliability were excellent (ICC ≥0.97 for all). For every degree increase in rotation, tilt, and obliquity, the ACEA changed by +0.53°, +0.93°, and –0.04°, respectively. The mean clockface location (hour:minute:second) in the false-profile view was 2:09:32 ± 0:12:00 and changed by +0:02:08, –0:00:35, and –0:00:05 for every degree increase in rotation, tilt, and obliquity, respectively. CONCLUSION: ACEA measurements were reliable even with differences in patient positioning. Rotation and tilt were associated with notable changes in ACEA measurements. ACEA bone edge measurements mapped to the anterosuperior acetabular rim, typically in proximity to the anterior inferior iliac spine. Mapped location was most sensitive to rotation. CLINICAL RELEVANCE: Pelvic rotation and tilt affected ACEA measurements, which could alter the clinical classification and treatment of borderline abnormalities. Rotation in particular must be well controlled during patient imaging to preserve measurement reliability and accuracy and to describe coverage from the intended 3D rim location. |
format | Online Article Text |
id | pubmed-8819774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-88197742022-02-08 Effect of Patient Positioning on Measurement of the Anterior Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to the Acetabular Rim Mozingo, Joseph D. Schuring, Lindsay L. Mortensen, Alexander J. Anderson, Andrew E. Aoki, Stephen K. Orthop J Sports Med Article BACKGROUND: The anterior center-edge angle (ACEA) is used to quantify anterior coverage of the femoral head by the acetabulum. However, its measurement has not been evaluated in a manner consistent with routine use, and the precise 3-dimensional (3D) anatomic location where it measures coverage is not known. PURPOSE: To determine the effect of patient positioning on ACEA measurement reliability, magnitude, and 3D location. STUDY DESIGN: Descriptive laboratory study. METHODS: Included were 18 adults; 7 participants had cam morphology and femoroacetabular impingement syndrome, and 11 participants had no radiographic evidence of hip abnormalities and no history of hip pain or injuries. Ultimately, 3D femur and pelvis models were generated from computed tomography images. Radiographs were generated with the models in different degrees of pelvic rotation, tilt, and obliquity relative to the standard false-profile view. The ACEA was measured by 2 raters by selecting the location of the bone edge on each radiograph. Selections were projected onto the pelvis model and expressed as a clockface location on the acetabular rim. The clockface was mirrored on left hips to allow a direct comparison of locations between hips. Interrater and intrarater reliability were quantified via the intraclass correlation coefficient (ICC). The effect of position on ACEA measurements and clockface locations was determined via linear regression. RESULTS: Intrarater and interrater reliability were excellent (ICC ≥0.97 for all). For every degree increase in rotation, tilt, and obliquity, the ACEA changed by +0.53°, +0.93°, and –0.04°, respectively. The mean clockface location (hour:minute:second) in the false-profile view was 2:09:32 ± 0:12:00 and changed by +0:02:08, –0:00:35, and –0:00:05 for every degree increase in rotation, tilt, and obliquity, respectively. CONCLUSION: ACEA measurements were reliable even with differences in patient positioning. Rotation and tilt were associated with notable changes in ACEA measurements. ACEA bone edge measurements mapped to the anterosuperior acetabular rim, typically in proximity to the anterior inferior iliac spine. Mapped location was most sensitive to rotation. CLINICAL RELEVANCE: Pelvic rotation and tilt affected ACEA measurements, which could alter the clinical classification and treatment of borderline abnormalities. Rotation in particular must be well controlled during patient imaging to preserve measurement reliability and accuracy and to describe coverage from the intended 3D rim location. SAGE Publications 2022-02-04 /pmc/articles/PMC8819774/ /pubmed/35141341 http://dx.doi.org/10.1177/23259671211073834 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Mozingo, Joseph D. Schuring, Lindsay L. Mortensen, Alexander J. Anderson, Andrew E. Aoki, Stephen K. Effect of Patient Positioning on Measurement of the Anterior Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to the Acetabular Rim |
title | Effect of Patient Positioning on Measurement of the Anterior
Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to
the Acetabular Rim |
title_full | Effect of Patient Positioning on Measurement of the Anterior
Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to
the Acetabular Rim |
title_fullStr | Effect of Patient Positioning on Measurement of the Anterior
Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to
the Acetabular Rim |
title_full_unstemmed | Effect of Patient Positioning on Measurement of the Anterior
Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to
the Acetabular Rim |
title_short | Effect of Patient Positioning on Measurement of the Anterior
Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to
the Acetabular Rim |
title_sort | effect of patient positioning on measurement of the anterior
center-edge angle on false-profile radiographs and its 3-dimensional mapping to
the acetabular rim |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8819774/ https://www.ncbi.nlm.nih.gov/pubmed/35141341 http://dx.doi.org/10.1177/23259671211073834 |
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