Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: Measurements reproductibility with EOS imaging system versus conventional radiographies

Lazennec, Jean-Yves; Rousseau, M.-A.; Rangel, Alfonso Calderón; Gorin, Michael A.; Belicourt, C.; Brusson, Adrien; Catonné, Yves

doi:10.1016/j.otsr.2011.02.006

Cited by 145 publications

(114 citation statements)

References 19 publications

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“…Stratified by pincer size, rotation, and tilt, the intermodality ICCs showed excellent reliability between EOS 1 and conventional radiography in morphologic features of the pincer. Our study also is consistent with previous EOS 1 imaging studies, which all showed an image quality of EOS 1 comparable to improved compared with that of conventional radiography [1,6,17,18,20,24,31]. However, we did see relative horizontal widening of the image in EOS 1 with extreme anterior tilt (C 10°) and horizontal narrowing in extreme posterior tilt (C 10°) owing to the decrease or increase in distance between the x-ray beam and the pelvis (Fig.…”

Section: Discussionsupporting

confidence: 92%

“…Radiation doses of EOS 1 have been reported as eight to 10 times less than conventional radiography and 800 to 1000 times less than CT [15,20,31]. A couple studies have validated the use and reliability of EOS 1 in imaging of the hip and lower extremities [18,31]. At this time, we are unaware of any studies showing the ability of EOS 1 to reliably measure established hip parameters in morphologic pincer features at varying degrees of tilt and rotation [27].…”

Section: Introductionmentioning

confidence: 99%

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Reliability of Overcoverage Parameters With Varying Morphologic Pincer Features: Comparison of EOS® and Radiography

Monazzam¹,

Agashe²,

Hosalkar³

2013

Clinical Orthopaedics &Amp; Related Research

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Background Multiple radiographic parameters used for diagnosis and quantification of morphologic pincer features have emerged, but the degree to which pelvic tilt or rotation affects conventional radiography and EOS 1 is unknown. Question/purposes We asked: (1) What is the reliability of EOS 1 and conventional radiography at increasing sizes of morphologic pincer features with varying degrees of tilt and rotation? (2) What is the effect of tilt and rotation on acetabular overcoverage measurements? Methods Using a dry cadaveric pelvis, AP conventional radiographs and EOS 1 images were taken at intervals of increasing modeled pincer size with 0°to 15°varying tilt and rotation. Lateral center-edge angle, Sharp angle, Tönnis angle, crossover sign, and retroversion index were measured on all images. Statistical analysis was conducted. Results The intermodality intraclass correlation coefficients for conventional radiography and EOS 1 radiography across all pincer sizes, rotations, and tilts were excellent (0.93-0.98). Crossover sign was in perfect agreement in conventional radiography and EOS 1 . Rotation of the hip away from the beam source and/or increased anterior tilt falsely increased all overcoverage parameters except for Tönnis angle. Rotation away from the beam of 10°or greater or anterior tilt of 5°or greater produced a false-positive crossover sign. Conclusions EOS 1 radiography maintained excellent reliability in comparison to conventional radiography but both were equally vulnerable to the effects of tilt and rotation for quantification of hip parameters used in acetabular overcoverage assessment. A standardized pelvic radiograph ensuring that the pelvis is not excessively tilted or rotated should be used for assessing acetabular overcoverage parameters.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Reliability of Overcoverage Parameters With Varying Morphologic Pincer Features: Comparison of EOS® and Radiography

Monazzam¹,

Agashe²,

Hosalkar³

2013

Clinical Orthopaedics &Amp; Related Research

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“…Previous studies have measured pelvic tilt in patients undergoing THA during sitting and standing positions, usually reporting values similar to ours with mean standing sacral slope angles between 35°and 40°, and mean sitting sacral slope angles between 14°and 24° [19,22,26]. Our study is the first, to our knowledge, to stratify patients undergoing THA into those with or without lumbar DDD, and we found that most patients with DDD had flattened backs (mean 7°less lumbar lordosis) and more posterior pelvic tilt (mean 5°more sacral slope) in standing.…”

Section: Discussionsupporting

confidence: 81%

Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

Esposito

Miller

Kim

et al. 2016

Clinical Orthopaedics &Amp; Related Research

201

177

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Background Sitting pelvic tilt dictates the proximity of the rim of the acetabulum to the proximal femur and, therefore, the risk of impingement in patients undergoing total hip arthroplasty (THA). Sitting position is achieved through a combination of lumbar spine segmental motions and/or femoroacetabular articular motion in the lumbarpelvic-femoral complex. Multilevel degenerative disc disease (DDD) may limit spine flexion and therefore increase femoroacetabular flexion in patients having THAs, but this has not been well characterized. Therefore, we measured standing and sitting lumbar-pelvic-femoral alignment in patients with radiographic signs of DDD and in patients with no radiographic signs of spine arthrosis.Questions/purposes We asked: (1) Is there a difference in standing and sitting lumbar-pelvic-femoral alignment before surgery among patients undergoing THA who have no radiographic signs of spine arthrosis compared with those with preexisting lumbar DDD? (2) Do patients with lumbar DDD experience less spine flexion moving from a standing to a sitting position and therefore compensate with more femoroacetabular flexion compared with patients who have no radiographic signs of arthrosis? Methods Three hundred twenty-five patients undergoing primary THA had preoperative low-dose EOS spine-toankle lateral radiographs in standing and sitting positions. Eighty-three patients were excluded from this study for scoliosis (39 patients), spondylolysis (15 patients), not having five lumbar vertebrae (7 patients), surgical or disease fusion (11 patients), or poor image quality attributable to high BMI (11 patients). In the remaining 242 of 325 patients (75%), two observers categorized the lumbar spine as either without radiographic arthrosis or having DDD based on defined radiographic criteria. Sacral slope, lumbar lordosis, and proximal femur angles were measured, and these angles were used to calculate lumbar spine flexion and femoroacetabular flexion in standing and sitting positions. Patients were aligned in a standardized sitting position so that their femurs were parallel to the floor to achieve approximately 90°of apparent hip flexion. Results After controlling for age, sex, and BMI, we found patients with DDD spines had a mean of 5°more posterior pelvic tilt (95% CI, À2°to À8°lower sacral slope angles; p \0.01) and 7°less lumbar lordosis (95% CI, À10°to À3°; p \ 0.01) in the standing position compared with patients without radiographic arthrosis. However, in the sitting position, patients with DDD spines had 4°less posterior pelvic tilt (95% CI, 1°-7°higher sacral slope angles; p = 0.02). From standing to sitting position, patients with DDD

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“…All patients were imaged by conventional radiography and by a slot scanning, x-ray system (EOS1; Biospace, Paris, France) [17,39,[41][42][43]70]. Implant orientations and contact patch to rim distance (CPR) [36] data were incorporated in each image.…”

Section: Standard Radiography and Eosmentioning

confidence: 99%

“…1), surgical positioning, and effects of ''edge loading'' [12,23,29,38,58,59,76]. Additionally, impingement, subluxation, and dislocation have always been unpredictable risk considerations [3,18,22,24,27,28,31,43,52,66,72,74,77,80]. Aggressive third-body abrasive wear can be one result of THA impingement [10,24,26,27,50].…”

Section: Introductionmentioning

confidence: 99%

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

Clarke

Lazennec

Savisaar

et al. 2013

Clin Orthop Relat Res

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Background Concerns have been raised about the sequelae of metal-on-metal (MoM) bearings in total hip arthroplasty (THA). However, retrieval studies, which offer the best insight into the clinically relevant mechanisms of MoM wear, have followed predictable trends to date such as indicting cobalt-chromium (CoCr) metallurgy, cup design, high conformity between the head and cup, ''steep cups,'' ''microseparation,'' and ''edge wear.'' Questions/purposes We wished to evaluate a set of retrieved 28-mm MoM THA for signs of (1) cup-to-stem impingement; (2) normal wear pattern and concomitant stripe damage on femoral heads that would signify adverse wear mechanics; and (3) well-defined evidence of thirdbody scratches on bearings that would indicate large abrasive particles had circulated the joint space. Methods Ten 28-mm MOM retrievals were selected on the basis that femoral stems were included. Revision surgeries at 3 to 8 years were for pain, osteolysis, and cup loosening. CoCr stems and the MoM bearings were produced by one vendor and Ti6Al4V stems by a second vendor. All but two cases had been fixed with bone cement. We looked for patterns of normal wear and impingement signs on femoral necks and cup rims. We looked for adverse wear defined as stripe damage that was visually apparent on each bearing. Wear patterns were examined microscopically to determine the nature of abrasions and signs of metal transfer. Graphical models recreated femoral neck and cup designs to precisely correlate impingement sites on femoral necks to cup positions and head stripe patterns.

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Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: Measurements reproductibility with EOS imaging system versus conventional radiographies

Abstract: Level III. Prospective diagnostic study.

Cited by 145 publications

References 19 publications

Reliability of Overcoverage Parameters With Varying Morphologic Pincer Features: Comparison of EOS® and Radiography

Reliability of Overcoverage Parameters With Varying Morphologic Pincer Features: Comparison of EOS® and Radiography

Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

Risk of Impingement and Third-body Abrasion With 28-mm Metal-on-metal Bearings

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