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Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study
Background and Objectives: Intraoperative fluoroscopy can be used to increase the accuracy of the acetabular component positioning during total hip arthroplasty. However, given the three-dimensional nature of cup positioning, it can be difficult to accurately assess inclination and anteversion angle...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147218/ https://www.ncbi.nlm.nih.gov/pubmed/35630080 http://dx.doi.org/10.3390/medicina58050663 |
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author | Brady, Alex W. Tatka, Jakub Fagotti, Lorenzo Kemler, Bryson R. Fossum, Bradley W. |
author_facet | Brady, Alex W. Tatka, Jakub Fagotti, Lorenzo Kemler, Bryson R. Fossum, Bradley W. |
author_sort | Brady, Alex W. |
collection | PubMed |
description | Background and Objectives: Intraoperative fluoroscopy can be used to increase the accuracy of the acetabular component positioning during total hip arthroplasty. However, given the three-dimensional nature of cup positioning, it can be difficult to accurately assess inclination and anteversion angles based on two-dimensional imaging. The purpose of this study is to validate a novel method for calculating the 3D orientation of the acetabular cup from 2D fluoroscopic imaging. Materials and Methods: An acetabular cup was implanted into a radio-opaque pelvis model in nine positions sequentially, and the inclination and anteversion angles were collected in each position using two methods: (1) a coordinate measurement machine (CMM) was used to establish a digitalized anatomical coordinate frame based on pelvic landmarks of the cadaveric specimen, and the 3D position of the cup was then expressed with respect to the anatomical planes; (2) AP radiographic images were collected, and a mathematical formula was utilized to calculate the 3D inclination and anteversion based on the 2D images. The results of each method were compared, and interrater and intrarater reliably of the 2D method were calculated. Results: Interrater reliability was excellent, with an interclass correlation coefficient (ICC) of 0.988 (95% CI 0.975–0.994) for anteversion and 0.997 (95% CI 0.991–0.999) for inclination, as was intrarater reliability, with an ICC of 0.995 (95% CI 0.985–0.998) for anteversion and 0.998 (95% CI 0.994–0.999) for inclination. Intermethod accuracy was excellent with an ICC of 0.986 (95% CI: 0.972–0.993) for anteversion and 0.993 (95% CI: 0.989–0.995) for inclination. The Bland–Altman limit of agreement, which represents the error between the 2D and 3D methods, was found to range between 2 to 5 degrees. Conclusions: This data validates the proposed methodology to calculate 3D anteversion and inclination angles based on 2D fluoroscopic images to within five degrees. This method can be utilized to improve acetabular component placing intraoperatively and to check component placement postoperatively. |
format | Online Article Text |
id | pubmed-9147218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91472182022-05-29 Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study Brady, Alex W. Tatka, Jakub Fagotti, Lorenzo Kemler, Bryson R. Fossum, Bradley W. Medicina (Kaunas) Article Background and Objectives: Intraoperative fluoroscopy can be used to increase the accuracy of the acetabular component positioning during total hip arthroplasty. However, given the three-dimensional nature of cup positioning, it can be difficult to accurately assess inclination and anteversion angles based on two-dimensional imaging. The purpose of this study is to validate a novel method for calculating the 3D orientation of the acetabular cup from 2D fluoroscopic imaging. Materials and Methods: An acetabular cup was implanted into a radio-opaque pelvis model in nine positions sequentially, and the inclination and anteversion angles were collected in each position using two methods: (1) a coordinate measurement machine (CMM) was used to establish a digitalized anatomical coordinate frame based on pelvic landmarks of the cadaveric specimen, and the 3D position of the cup was then expressed with respect to the anatomical planes; (2) AP radiographic images were collected, and a mathematical formula was utilized to calculate the 3D inclination and anteversion based on the 2D images. The results of each method were compared, and interrater and intrarater reliably of the 2D method were calculated. Results: Interrater reliability was excellent, with an interclass correlation coefficient (ICC) of 0.988 (95% CI 0.975–0.994) for anteversion and 0.997 (95% CI 0.991–0.999) for inclination, as was intrarater reliability, with an ICC of 0.995 (95% CI 0.985–0.998) for anteversion and 0.998 (95% CI 0.994–0.999) for inclination. Intermethod accuracy was excellent with an ICC of 0.986 (95% CI: 0.972–0.993) for anteversion and 0.993 (95% CI: 0.989–0.995) for inclination. The Bland–Altman limit of agreement, which represents the error between the 2D and 3D methods, was found to range between 2 to 5 degrees. Conclusions: This data validates the proposed methodology to calculate 3D anteversion and inclination angles based on 2D fluoroscopic images to within five degrees. This method can be utilized to improve acetabular component placing intraoperatively and to check component placement postoperatively. MDPI 2022-05-14 /pmc/articles/PMC9147218/ /pubmed/35630080 http://dx.doi.org/10.3390/medicina58050663 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Brady, Alex W. Tatka, Jakub Fagotti, Lorenzo Kemler, Bryson R. Fossum, Bradley W. Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title | Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title_full | Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title_fullStr | Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title_full_unstemmed | Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title_short | Accuracy and Reliability of Software Navigation for Acetabular Component Placement in THA: An In Vitro Validation Study |
title_sort | accuracy and reliability of software navigation for acetabular component placement in tha: an in vitro validation study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147218/ https://www.ncbi.nlm.nih.gov/pubmed/35630080 http://dx.doi.org/10.3390/medicina58050663 |
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