A new method and its application for predicting acetabular cup prosthesis size before total hip arthroplasty based on X-ray imaging
Objective:To introduce a new method for predicting acetabular cup prosthesis size before total hip arthroplasty(THA)based on X-ray imaging.Methods:A retrospective analysis was conducted on 86 patients with osteonecrosis of the femoral head who underwent THA at the First Medical Center of Chinese People's Liberation Army General Hospital from June 2021 to March 2022.The pelvic height was measured preoperatively from the standard anteroposterior pelvic X-ray imaging of all patients.A simple random sampling method was used to select 45 patients who underwent THA during the same period in the hospital,and the preoperative hip joint three-dimensional CT scan images were processed using the Mako robotic computer operating system to establish a three-dimensional pelvic model.The pelvic height was measured at standard 0°,anteroposterior tilt(5°,10°,15°),and retroverted tilt(5°,10°,15°)angles.A simple linear regression model was used to analyze the relationship between the pelvic height and the outer diameter of the acetabular cup.The intraclass correlation coefficient(ICC)between the predicted and actual outer diameter of the acetabular cup was calculated.Results:A linear relationship was observed between the pelvic height and the outer diameter of the acetabular cup in all 86 patients,and the simple linear regression equation was as follows:outer diameter of the acetabular cup=24.82+(pelvic height×0.13)(P<0.001).The ICC between the predicted and actual outer diameter of the acetabular cup was 0.757(P<0.001),indicating good repeatability.The maximum difference in pelvic height measured at the seven positions within 15° of anteversion and retroversion was 5.8 mm.Conclusions:There is a linear relationship between the preoperative pelvic height on the standard anteroposterior pelvic X-ray imaging and the actual used outer diameter of the acetabular cup.It is feasible to use the pelvic height on preoperative X-ray imaging to predict the actual acetabular cup prosthesis size used in THA.The impact of pelvic anteversion and retroversion within 15° on X-ray imaging to predict the acetabular cup prosthesis size using this method is minimal.
Total Hip ArthroplastyPelvic HeightAcetabular CupPreoperative Planning
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NSTL
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