Fluoroscopic Categorization of Cementless Acetabular Component Positioning

 

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Abstract

Objectives The purpose of this study was to evaluate a fluoroscopic method of angle of lateral opening (ALO) categorization based on identification of the visible portion of a pre-existing, circular recess within the metal shell of the BioMedtrix BFX acetabular component, which projects as an ellipse at clinically relevant ALO values. Our hypothesis was that there will be an association between the actual ALO and the categorization of ALO based on identification of the visible portion of the elliptical recess on a lateral fluoroscopic image at clinically relevant values.

Study Design A custom plexiglass jig was fitted with a two-axis inclinometer and a 24 mm BFX acetabular component attached to its tabletop. Fluoroscopic reference images were obtained with the cup positioned at an ALO of 35, 45 and 55 degrees with a fixed 10 degrees of retroversion. Thirty study fluoroscopic images (10 images at each ALO) were obtained based on randomization at an ALO of 35, 45 and 55 degrees (±0.5 degrees) with 10 degrees of retroversion. The order of the study images was randomized, and a single, blinded observer categorized the 30 study images as representing an ALO of 35, 45 or 55 degrees by comparison to the reference images.

Results Analysis showed perfect (30/30) agreement with a weighted kappa coefficient of 1 (95% confidence interval: −0.717 to 1).

Clinical Relevance The results demonstrate that accurate categorization of ALO can be achieved using this fluoroscopic method. This method may prove to be a simple but effective method of estimating intraoperative ALO.

Authors' Contributions

All authors contributed to the study design. W.M.K. and M.P.K. contributed to the data acquisition. All authors contributed to analysis and interpretation of the data. All authors drafted and revised the manuscript and approved submission.

Note

This study was presented in part at the AO VET Clinical Research Virtual Symposium 5 December 2021 and at the Veterinary Orthopedic Society 49^th Annual Conference in Snowmass Colorado, 7 February 2022.

Publication History

Received: 08 July 2022

Accepted: 21 December 2022

Article published online:
22 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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