American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: http://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
Open Access
Journal Browser
Go
American Journal of Clinical Medicine Research. 2014, 2(3), 57-60
DOI: 10.12691/ajcmr-2-3-2
Open AccessArticle

Are Measurements of Sacral Slopes Reliable?

Norio Imai1, , Dai Miyasaka1, Yoji Horigome1, Hayato Suzuki1, Ryota Takubo1 and Naoto Endo1

1Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan

Pub. Date: June 15, 2014

Cite this paper:
Norio Imai, Dai Miyasaka, Yoji Horigome, Hayato Suzuki, Ryota Takubo and Naoto Endo. Are Measurements of Sacral Slopes Reliable?. American Journal of Clinical Medicine Research. 2014; 2(3):57-60. doi: 10.12691/ajcmr-2-3-2

Abstract

Background: Malpositioning during total hip arthroplasty may cause dislocation, pain, and other complications. To evaluate the potential of sacral slope (SS) as a reliable parameter of pelvic flexion. Methods: We developed a model of pelvic flexion to determine the intraobserver and interobserver variability and reliability of SS measurements by lateral radiography by three independent observers. Results: Measurement error was 1.2 and the intraobserver reliability was moderate to substantial (Interclass correlation coefficient: 0.31 to 0.66). Based on the Spearman-Brown formula, the measurement is reliable if it is done at least seven times by two observers, and four times by three observers. Conclusions: The data suggest that measurement of SS of pelvic flexion is a clinically useful parameter for the optimization of THA conditions.

Keywords:
anterior pelvic plane lateral radiograph total hip arthroplasty sacral slope pelvic flexion angle accuracy

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Kummer, F,J., Shah, S., Iyer, S. and DiCesare, P,E,. “The effect of acetabular cup orientations on limiting hip rotation,” J Arthroplasty. 14(4). 509-13. 1999.
 
[2]  Zhu, J., Wan, Z. and Dorr, L, D,. “Quantification of pelvic tilt in total hip arthroplasty,” Clin Orthop Relat Res. 468(2). 571-5. 2010.
 
[3]  Malik, A., Maheshwari, A. and Dorr, L, D, “Impingement with total hip replacement,” J Bone Joint Surg Am. 89(8). 1832-42.2007.
 
[4]  Dorr, L,D., Malik, A., Dastane, M. and Wan, Z., “Combined anteversion technique for total hip arthroplasty,” Clin Orthop Relat Res. 467(1). 119-27. 2009.
 
[5]  Widmer, K,H. and Zurfluh, B., “Compliant positioning of total hip components for optimal range of motion,” J Orthop Res. 22(4). 815-21. 2004.
 
[6]  Yoshimine, F,. “The safe-zones for combined cup and neck anteversions that fulfill the essential range of motion and their optimum combination in total hip replacements,” J Biomech. 39(7). 1315-23. 2006.
 
[7]  DiGioia, A,M,. Jaramaz, B. and Blackwel,l M., “The Otto Aufranc Award. Image guided navigation system to measure intraoperatively acetabular implant alignment, “Clin Orthop Relat Res”. (355). 8-22. 1998.
 
[8]  Lewinneck, G,E., Lewis, J,L. Tarr, R., Compere, C,L. and Zimmerman, J,R., “Dislocation after total hip-replacement arthroplasties”. J Bone Joint Surg Am. 60(2). 217-20. 1978.
 
[9]  DiGioia, A,M,. Hafez, M,A,. Jaramaz, B., Levison, T,J. and Moody, J,E., ”Functional pelvic orientation measured from lateral standing and sitting radiographs”. Clin Orthop Relat Res. 453. 272-6. 2006.
 
[10]  Kalteis, T,A., Handel, M., Herbst, B., Grifka, J. and Renkawitz, T., ”In vitro investigation of the influence of pelvic tilt on acetabular cup alignment”. J Arthroplasty. 24(1). 152-7. 2009.
 
[11]  Lembeck, B., Mueller, O., Reize, P. and Wuelker, N., “Pelvic tilt makes acetabular cup navigation inaccurate”. Acta Orthop. 76(4). 517-23. 2005.
 
[12]  Parratte, S. and Argenson, J,N., “Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. A prospective, randomized, controlled study”. J Bone Joint Surg Am. 89(3). 494-9. 2007.
 
[13]  Blondel, B,. Parratte, S., Tropiano, P,. Pauly, V., Aubaniac, J,M. and Argenson, J,N., “Pelvic tilt measurement before and after total hip arthroplasty”. Orthop Traumatol Surg Res. 95(8). 568-72.2009.
 
[14]  Eckman, K., Hafez, M,A., Jaramaz, B., Levison, T,J. and Digioia, A,M, 3rd., “Accuracy of pelvic flexion measurements from lateral radiographs”. Clin Orthop Relat Res. 451. 154-60. 2006.
 
[15]  Legaye, J., “The femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum”. Eur Spine J. 16(2). 219-25. 2007.
 
[16]  Babisch, J,W., Layher, F. and Amiot, L,P., “The rationale for tilt-adjusted acetabular cup navigation”. J Bone Joint Surg Am. 90(2). 357-65. 2008.
 
[17]  Nishihara, S., Sugano, N., Nishii, T., Ohzono, K. and Yoshikawa, H., “Measurements of pelvic flexion angle using three-dimensional computed tomography”. Clin Orthop Relat Res. 411. 140-51. 2003.
 
[18]  Kobayashi, K., Sakamoto, M. and Tanabe, Y., “Automated image registration for assessing three-dimensional alignment of entire lower extremity and implant position using bi-plane radiography”. J Biomech. 42(16). 2818-22. 2009.
 
[19]  Tannast, M., Zheng, G. and Anderegg, C., “Tilt and rotation correction of acetabular version on pelvic radiographs”. Clin Orthop Relat Res. 438. 182-90. 2005.
 
[20]  Ben-Galim, P., Ben-Galim, T. and Rand, N., “Hip-spine syndrome: the effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip”. Spine. 32(19). 2099-102. 2007.
 
[21]  Jackson, R,P., Kanemura, T., Kawakami, N. and Hales C., “Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain”. Spine. 25(5), 575-86. 2000.
 
[22]  Offierski, C,M. and MacNab, I., “Hip-spine syndrome”. Spine. 8(3). 316-21. 1983.
 
[23]  Yoshimoto, H., Sato, S. and Masuda, T., “Spinopelvic alignment in patients with osteoarthrosis of the hip: a radiographic comparison to patients with low back pain”. Spine. 30(14). 1650-7. 2005.
 
[24]  Imai, N., Ito, T., Suda, K., Miyasaka, D. and Endo, N., “Pelvic flexion measurement from lateral projection radiographs is clinically reliable”. Clin Orthop Relat Res. 471(4). 1271-6. 2013.
 
[25]  Ariumi, A., Sato, T. and Kobayashi, K., “Three-dimensional lower extremity alignment in the weight-bearing standing position in healthy elderly subjects”. J Orthop Sci. 15(1). 64-70. 2010.
 
[26]  Sato, T., Koga, Y. and Omori, G., “Three-dimensional lower extremity alignment assessment system: application to evaluation of component position after total knee arthroplasty”. J Arthroplasty. 19(5). 620-8. 2004.
 
[27]  Allinson, P,D., “A simple proof of the Spearman-Brown formula for continuous test lengths”. Psychometriaka. 40. 135. 1975.