Radiographic Examination at Lateral Decubitus Position for Reducing the Variability of Cup Inclination

Kye Young Han; Sang Gi Cho

doi:10.4055/jkoa.2009.44.4.408

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Han and Cho: Radiographic Examination at Lateral Decubitus Position for Reducing the Variability of Cup Inclination

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(4): 408-413.

Published online: 21 July 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.4.408

Radiographic Examination at Lateral Decubitus Position for Reducing the Variability of Cup Inclination

Kye Young Han, M.D., Sang Gi Cho, M.D.

Department of Orthopedic Surgery, Kangwon National University College of Medicine and The Clinical Research Institute of Kangwon National University Hospital, Chuncheon, Korea.

Correspondence to Kye Young Han, M.D. Department of Orthopedic Surgery, Kangwon National University Hospital, 17-1 Hyoja 3-dong, Chuncheon 220-722, Korea. Tel: +82.33-258-2308, Fax: +82.33-244-2205, hkyljh@kangwon.ac.kr

Received 22 February 2009 Accepted 25 May 2009

Abstract

Purpose

This study analyzed the factors related to a variable inclination angle in patients who have undergone total hip arthroplasty by taking pelvis AP X-rays in the lateral decubitus position with a 45° targeted goniometer.

Materials and Methods

We recruited 100 adults (50 men and 50 women) who were without a history of hip joint disease. The mean age was 30.1 years for the men and 33.7 years for the women. The circumferences of the shoulder and pelvis, the shoulder to pelvis ratio, and the body mass index were checked. We examined the radiographs with using a goniometer, which was targeted to 45° for allowing a rod to be across the center of the acetabulum. The cross angle between the rod and the interteardrop line was checked.

Results

On the comparison of the gender groups, the shoulder to pelvis ratio was on average 1.18 in men and it was 1.08 in women. The mean cross angle was 45.3° in men and 48.1° in women. As the ratio was increased, the cross angle decreased.

Conclusion

For men, there was little pelvic tilt in the lateral decubitus position. But for women, if inserting the acetabular cup with the acetabular orientation at 45° is done without considering the pelvic tilt inclination at the lateral decubitus position, then the inclination angle could be lower than expected.

Keywords: Hip, Total hip arthroplasty, Inclination angle, Lateral decubitus position, Goniometer

Figures and Tables

Fig. 1

Simple goniometer with long indicator targeted to 45° for measuring the pelvic tilt.

Fig. 2

The photograph of the anteroposterior radiograph imaging technique in lateral decubitus position using goniometer.

Fig. 3

Methods for cross angle. Anteroposterior radiograph was obtained with goniometer rod targeted 45° in lateral decubitus position. An angle between the interteardrop line and goniometer rod was measured and the designated pelvic tilt angle. The pelvis was considered to tilt to cranially.

Table 1

Comparision of Body Profile and Cross Angle by Gender

^*Independent samples t-test.

Table 2

The Comparison of Cross Angle according to Shoulder/Pelvis Ratio

^*One Way ANOVA Test.

Table 3

Comparison of Cross Angle according to BMI

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