scholarly journals Interobserver and Intraobserver Reliabilities of Three-Dimensional Postoperative Evaluation Software in Total Hip Arthroplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Kenta Konno ◽  
Shigeo Hagiwara ◽  
Junichi Nakamura ◽  
Yuya Kawarai ◽  
Sumihisa Orita ◽  
...  

Background. In primary and revision total hip arthroplasty, to prevent perioperative complications, the prediction of the optimal implant size is essential. Using three-dimensional computed tomography-based postoperative evaluation software, we explored the accuracy and the precision of measurement of the size, alignment, and position of the prosthetic components after total hip arthroplasty. Methods. Using postoperative evaluation software, the postoperative computed tomography data from 20 hips in 20 patients were evaluated. The component size, alignment, and three-dimensional positioning of the cup and stem were assessed. The concordance rates of the component, repeatability (intraobserver reliability), and reproducibility (interobserver reliability) of postoperative evaluation were calculated. The radiographic inclination and radiographic anteversion of the cup, anteversion, varus–valgus angle, and flexion–extension angles of the stem were measured for alignment. The implant positioning was measured along three axes, namely, X-axis (transverse), Y-axis (sagittal), and Z-axis (longitudinal). Results. The concordance rates of all parts are above 94%. The intraobserver and interobserver intraclass correlation coefficients of alignment measurement were very good for both cup (0.879–0.964) and stem (0.973–0.996). The intraobserver and interobserver intraclass correlation coefficients of cup positioning were very good (0.961–0.987) for all axes. The intraobserver and interobserver intraclass correlation coefficients of implant positioning were very good for the stem (0.879–0.995) for all axes. Conclusions. Computed tomography-based postoperative evaluation software was able to evaluate the size and position of total hip implants with high reproducibility.

2020 ◽  
Author(s):  
Kenta Konno ◽  
Shigeo Hagiwara ◽  
Junichi Nakamura ◽  
Satoshi Yoh ◽  
Kensuke Yoshino ◽  
...  

Abstract Background: We investigated the reliability of measurement of the alignment and position of the prosthetic components after total hip arthroplasty (THA) using three-dimensional computed tomography (CT)-based postoperative evaluation software.Methods: We evaluated the postoperative CT data from 20 hips in 20 patients, using postoperative evaluation software. The alignment and three-dimensional positioning of the cup and stem were assessed by eight orthopedic surgeons for repeatability (intraobserver reliability) and reproducibility (interobserver reliability) of postoperative evaluation software using intra-class correlation coefficients (ICC). The radiographic inclination (RI) and radiographic anteversion (RA) of the cup, and anteversion, varus-valgus angle and flexion-extension angles of the stem were measured for alignment. The implant positioning was measured along three axes, X-axis (transverse), Y-axis (sagittal), and Z-axis (longitudinal).Results: The intra- and inter-observer ICC of alignment measurement were very good for both cup and stem (0.86–1.00). The intra-observer and inter-observer ICC of cup positioning were very good in X-axis and Y-axis (0.91–0.94) and good in Z-axis (0.68–0.80). The intra-observer and inter-observer ICC of implant positioning were very good for the stem (0.98–0.99) for all axes.Conclusion: CT-based postoperative evaluation software was able to evaluate the position of total hip implants with high reproducibility.


2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Sebastian Serong ◽  
Moritz Schutzbach ◽  
Ivica Zovko ◽  
Marcus Jäger ◽  
Stefan Landgraeber ◽  
...  

Abstract Background The recently described ‘critical trochanter angle’ (CTA) is a novel parameter in the preoperative risk assessment of stem malalignment in total hip arthroplasty. As its reproducibility needs to be evaluated, the given study aims to investigate intra- and interobserver reliability. It is hypothesized that both analyses justify the clinical use of the CTA. Methods A total of 100 pelvic radiographs obtained prior to total hip arthroplasty were retrospectively reviewed by four observers with different levels of clinical experience. The CTA was measured twice by each observer at different occasions in the previously described technique. Intra- and interobserver reliability was evaluated using intraclass correlation coefficients (ICC) with confidence intervals (CI) and the Bland–Altman approach. Results The mean CTA in both measuring sequences was 20.58° and 20.78°. The observers’ means ranged from 17.76° to 25.23°. Intraobserver reliability showed a mean difference of less than 0.5° for all four observers (95% limit of agreement: − 7.70–6.70). Intraobserver ICCs ranged from 0.92 to 0.99 (CI 0.88–0.99). For interobserver variation analysis, ICCs of 0.83 (CI 0.67–0.90) and 0.85 (CI 0.68–0.92) were calculated. Conclusion Analyses concerning intra- and interobserver reliability in the assessment of the CTA showed ‘very good’ and ‘good’ results, respectively. In view of these findings, the use of the CTA as an additional preoperative parameter to assess the risk of intraoperative stem malalignment seems to be justified.


2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110588
Author(s):  
Xuzhuang Ding ◽  
Bingshi Zhang ◽  
Wenao Li ◽  
Jia Huo ◽  
Sikai Liu ◽  
...  

Objective We performed a retrospective study to compare the accuracy of preoperative planning using three-dimensional AI-HIP software and traditional two-dimensional manual templating to predict the size and position of prostheses. The purpose of this study was to evaluate the accuracy of AI-HIP in preoperative planning for primary total hip arthroplasty. Methods In total, 316 hips treated from April 2019 to June 2020 were retrospectively reviewed. A typical preoperative planning process for patients was implemented to compare the accuracy of the two preoperative planning methods with respect to prosthetic size and position. Intraclass correlation coefficients (ICCs) were used to evaluate the homogeneity between the actual prosthetic size and position and the preoperative planning method. Results When AI-HIP software and manual templating were used for preoperative planning, the stem agreement was 87.7% and 58.9%, respectively, and the cup agreement was 94.0% and 65.2%, respectively. The results showed that when AI-HIP software was used, an extremely high level of consistency (ICC > 0.95) was achieved for the femoral stem size, cup size, and femoral osteotomy level (ICC = 0.972, 0.962, and 0.961, respectively). Conclusion AI-HIP software showed excellent reliability for predicting the component size and implant position in primary total hip arthroplasty.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pieter-Jan Verhelst ◽  
H. Matthews ◽  
L. Verstraete ◽  
F. Van der Cruyssen ◽  
D. Mulier ◽  
...  

AbstractAutomatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were < 2 mm, accounting for < 1% of the total variability of the centroid size of the mandibles in this sample. ICC’s for the multivariate set of 325 interlandmark distances were all > 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape.


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