USE OF SMARTPHONE IN ACETABULAR COMPONENT ANGLE MEASUREMENT DURING TOTAL HIP ARTHROPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WANGJing ¹ , XURui ² , KANGXuewen ¹ , ZHANGHaihong ¹

1. Department of Orthopedics, Orthopedics Key Laboratory of Gansu Province, Lanzhou University Second Hospital, Lanzhou Gansu, 730030, P. R. China;
2. Department of Radiology, Lanzhou University Second Hospital, Lanzhou Gansu, 730030, P. R. China;

Corresponding author：

WANGJing, Email: k.alpha@163.com

Keywords：

Total hip arthroplasty; Acetabular component; Smartphone; Anteversion angle; Abduction angle

DOI：

10.7507/1002-1892.20160216

Video：

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Objective To evaluate the accuracy of using smartphone to measure the angle of acetabular component in total hip arthroplasty (THA). Methods Between June 2012 and September 2015, the acetabular abduction and anteversion angles were measured in 50 patients undergoing THA. There were 24 males and 26 females, aged 37 to 83 years (mean, 71 years). The left hip was involved in 22 cases and the right hip in 28 cases. Of 50 patients, 34 suffered from fracture of the femoral neck, and 16 suffered from avascular necrosis of the femoral head. Acetabular dysplasia was excluded in all cases. A smartphone was used to measure the acetabular abduction and anteversion angles during operation; standard Picture Archiving and Communication Systems (PACS) was used to measured the acetabular abduction and anteversion angles on the X-ray film at 1 week after operation. It was defined as positive that the component angle values by PACS measurement were greater than those by the smartphone measurement, whereas as negative. The two measurement methods were compared, and intra-observer variability was assessed by analyzing the intraclass correlation coefficient (ICC), the Mann-Whitney U-test was used to analyze difference. Results The ICC was 0.84 in the acetabular component angles by smartphone and PACS measurement methods. The acetabular component abduction angle was (44.02±1.33)° and the anteversion angle was (17.62±2.20)° by smartphone measurement. The acetabular component abduction angle was (44.74±4.05)° and the anteversion angle was (17.22±5.57)° by PACS measurement. There was no significant difference between two measurement methods (Z=-1.977, P=0.482; Z=-0.368, P=0.713). The acetabular component angle was in the safe zone in 44 cases; and the acetabular component anteversion angle was beyond safe range of 1 to 5°, and the abduction angle was beyond safe range of 1 to 3° in 6 cases. Intra-measurement variability was -21 to +10° for the anteversion angle and -10 to + 9° for the abduction angle, indicating that the acetabular component anteversion angle by smartphone measurement was greater than that by the PACS measurement, and the abduction angle was less than that by PACS measurement. Conclusion Smartphone is a convenient tool to measure the acetabular component angle in THA.

Citation： WANGJing, XURui, KANGXuewen, ZHANGHaihong. USE OF SMARTPHONE IN ACETABULAR COMPONENT ANGLE MEASUREMENT DURING TOTAL HIP ARTHROPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(9): 1061-1064. doi: 10.7507/1002-1892.20160216 Copy

1.	Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2):217-220.
2.	Miyoshi H, Mikami H, Oba K, et al. Anteversion of the acetabular component aligned with the transverse acetabular ligament in total hip arthroplasty. J Arthroplasty, 2012, 27(6):916-922.
3.	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.
4.	D'Lima DD, Urquhart AG, Buehler KO, et al. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg (Am), 2000, 82(3):315-321.
5.	Grammatopoulos G, Pandit H G, Da AR, et al. Pelvic position and movement during hip replacement. Bone Joint J, 2014, 96-B(7):876-883.
6.	Abdel MP, von Roth P, Jennings MT, et al. What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Ortho Relat Res, 2016, 474(2):386-391.
7.	曾晖, 刘国平, Michael Nogler, 等.手术导航系统提高全髋关节置换术中髋臼假体植入精确度的研究.中华创伤杂志, 2004, 20(7):418-420.
8.	Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2):228-232.
9.	Sotereanos NG, Miller MC, Smith B, et al. Using intraoperative pelvic landmarks for acetabular component placement in total hip arthroplasty. J Arthroplasty, 2006, 21(6):832-840.
10.	Archbold HA, Mockford B, Molloy D, et al. The transverse acetabular ligament:an aid to orientation of the acetabular component during primary total hip replacement:a preliminary study of 1000 cases investigating postoperative stability. J Bone Joint Surg (Br), 2006, 88(7):883-886.
11.	张福江, 高志国, 于建华, 等.全髋关节置换术中髋臼横韧带对髋臼假体前倾定位的研究.中国修复重建外科杂志, 2008, 22(5):625-626.
12.	Dorr LD, Malik A, Dastane M, et al. Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res, 2008, 467(1):119-127.
13.	Nakashima Y, Hirata M, Akiyama M, et al. Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty. Int Orthop, 2014, 38(1):27-32.
14.	Grammatopoulos G, Pandit HG, da Assunçăo R, et al. The relationship between operative and radiographic acetabular component orientation. Bone Joint J, 2014, 96(10):1290-1297.
15.	Ha YC, Yoo JJ, Lee YK, et al. Acetabular component positioning using anatomic landmarks of the acetabulum. Clin Orthop Relat Res, 2012, 470(12):3515-3523.
16.	Shaw M, Adam CJ, Izatt MT, et al. Use of the iPhone for Cobb angle measurement in scoliosis. Eur Spine J, 2012, 21(6):1062-1068.
17.	Esposito CI, Gladnick BP, Lee YY, et al. Cup position alone does not predict risk of dislocation after hip arthroplasty. J Arthroplasty, 2015, 30(1):109-113.
18.	Harrison CL, Thomson AI, Cutts S, et al. Research synthesis of recommended acetabular cup orientations for total hip arthroplasty. J Arthroplasty, 2013, 29(2):377-382.

1. Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2):217-220.
2. Miyoshi H, Mikami H, Oba K, et al. Anteversion of the acetabular component aligned with the transverse acetabular ligament in total hip arthroplasty. J Arthroplasty, 2012, 27(6):916-922.
3. 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.
4. D'Lima DD, Urquhart AG, Buehler KO, et al. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg (Am), 2000, 82(3):315-321.
5. Grammatopoulos G, Pandit H G, Da AR, et al. Pelvic position and movement during hip replacement. Bone Joint J, 2014, 96-B(7):876-883.
6. Abdel MP, von Roth P, Jennings MT, et al. What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Ortho Relat Res, 2016, 474(2):386-391.
7. 曾晖, 刘国平, Michael Nogler, 等.手术导航系统提高全髋关节置换术中髋臼假体植入精确度的研究.中华创伤杂志, 2004, 20(7):418-420.
8. Murray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg (Br), 1993, 75(2):228-232.
9. Sotereanos NG, Miller MC, Smith B, et al. Using intraoperative pelvic landmarks for acetabular component placement in total hip arthroplasty. J Arthroplasty, 2006, 21(6):832-840.
10. Archbold HA, Mockford B, Molloy D, et al. The transverse acetabular ligament:an aid to orientation of the acetabular component during primary total hip replacement:a preliminary study of 1000 cases investigating postoperative stability. J Bone Joint Surg (Br), 2006, 88(7):883-886.
11. 张福江, 高志国, 于建华, 等.全髋关节置换术中髋臼横韧带对髋臼假体前倾定位的研究.中国修复重建外科杂志, 2008, 22(5):625-626.
12. Dorr LD, Malik A, Dastane M, et al. Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res, 2008, 467(1):119-127.
13. Nakashima Y, Hirata M, Akiyama M, et al. Combined anteversion technique reduced the dislocation in cementless total hip arthroplasty. Int Orthop, 2014, 38(1):27-32.
14. Grammatopoulos G, Pandit HG, da Assunçăo R, et al. The relationship between operative and radiographic acetabular component orientation. Bone Joint J, 2014, 96(10):1290-1297.
15. Ha YC, Yoo JJ, Lee YK, et al. Acetabular component positioning using anatomic landmarks of the acetabulum. Clin Orthop Relat Res, 2012, 470(12):3515-3523.
16. Shaw M, Adam CJ, Izatt MT, et al. Use of the iPhone for Cobb angle measurement in scoliosis. Eur Spine J, 2012, 21(6):1062-1068.
17. Esposito CI, Gladnick BP, Lee YY, et al. Cup position alone does not predict risk of dislocation after hip arthroplasty. J Arthroplasty, 2015, 30(1):109-113.
18. Harrison CL, Thomson AI, Cutts S, et al. Research synthesis of recommended acetabular cup orientations for total hip arthroplasty. J Arthroplasty, 2013, 29(2):377-382.

Chinese Journal of Reparative and Reconstructive Surgery

USE OF SMARTPHONE IN ACETABULAR COMPONENT ANGLE MEASUREMENT DURING TOTAL HIP ARTHROPLASTY

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