Bokkers, Kyra (2012) Bepalen van de positionering van de heupkom na totale heupartroplastiek met behulp van EOS 3D : Een reproduceerbaarheidsonderzoek, het beoordelen van de nauwkeurigheid van computernavigatie & het beoordelen van de nauwkeurigheid van EOS 2D metingen. thesis, Medicine.
Full text available on request.Abstract
Introduction: Total hip arthroplasty (THA) is a very common procedure and its application is growing, due to better equipment and techniques, a broader range of ages and the rising prevalence of osteoarthritis of the hip. This makes it even more important to optimize the survival time of the new hip. The position of the cup plays a key role in the survival of the new hip. A safe zone is known, in which de cup must be placed to minimize this risk of dislocation. This safe zone comprises an inclination angle of 40 ± 10º and an anteversion angle of 15 ± 10º. Computer assisted surgery (CAS) has been developed to aid the operator in placing the cup with more accuracy. Nowadays, the position of the cup is postoperatively being measured on a conventional X-ray. Measuring the position of the cup on a conventional X-ray has, however, been determined unreliable. A new method has recently come available to analyze the position of the cup, called the EOS. This is an x-ray machine with which an anterior-posterior (AP) and a lateral x-ray can be made simultaneously. With the sterEOS software, these images can be used to make a three-dimensional reconstruction of the hip and the inclination and anteversion can be calculated. The reproducibility of this method has not yet been determined. Goal: The first goal is to determine the reproducibility of analyzing de position of the cup with EOS after a THA. De second goal is to determine with EOS if the cup can be placed more accurately with CAS. Finally, the inclination measured on the EOS AP-X-ray will be compared with the inclination measured on the conventional X-ray Materials and method: In this study 23 patients with 27 total hips were included. Five of these patients had been operated with computer navigation. A conventional X-ray and an EOS X-ray were taken of all patients. Subsequently, 3 observers measured the inclination and anteversion of the hips with the EOS software, with respect to the anterior pelvic plane (APP) en with respect to the patient plane (PP). One observer also measured the inclination on the EOS AP-X-ray’s and the conventional AP-X-ray’s. Results: The relative and absolute reliability was excellent for the intraobserver reliability with ICC’s ranging from 0,96 to 0,98. The interobserver reliability had also an excellent relative and absolute reliability, with ICC’s ranging from 0,90 to 0,98. Striking was that the range for measuring the anteversion with respect to the APP was very broad. De mean anteversion was significantly different between the control group and de CAS group. De anteversion of the CAS group was less accurate than the anteversion of the control group. No difference however was found between the control and CAS group for the total amount of outliers. There was a significant difference between the inclination measured on the EOS AP-X-ray’s and the inclination measured on the conventional AP-X-ray’s. There was also a significant difference between the inclination measured on the EOS AP-X-ray’s compared to the inclination measured with the sterEOS software (two-dimensional versus three-dimensional) Conclusion: The reproducibility for determining the positioning of the cup after a THA with EOS is excellent. No conclusion could be made about the use of computer navigation or the measurement of the inclination on de EOS AP-X-ray’s due to the small research population.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Bulstra, Prof. Dr. S.K. and Afdeling Orthopedie UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/187 |
Actions (login required)
 |
View Item |