Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs
Objective Evaluation of sagittal pelvic tilt is significant for hip surgeons. However, the accurate measurement of pelvic sagittal inclination (PSI) is still a challenge. The objective of this study is to propose a new method for measurement of PSI from pelvic anteroposterior radiograph based on the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13488 |
| _version_ | 1829097849545031680 |
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| author | Hao‐han Huang Yan Chen Zhao‐xun Chen Chang‐qing Zhao |
| author_facet | Hao‐han Huang Yan Chen Zhao‐xun Chen Chang‐qing Zhao |
| author_sort | Hao‐han Huang |
| collection | DOAJ |
| description | Objective Evaluation of sagittal pelvic tilt is significant for hip surgeons. However, the accurate measurement of pelvic sagittal inclination (PSI) is still a challenge. The objective of this study is to propose a new method for measurement of PSI from pelvic anteroposterior radiograph based on the inverse cosine function obtained from individualized pelvic model. Methods Collecting the imaging data of 30 patients with both pelvic CT and full‐length spine radiographs. Establishing pelvic model by customized 3D reconstruction software. The length of three groups of longitudinal and transverse line segments (A′p and B′) were measured from full‐length spine anteroposterior radiographs. The corresponding anatomical parameters, including A, B, b, ∠α, ∠γ, were measured and calculated on the same patient's pelvic model. The estimated PSI (ePSI) based on three groups of anatomical landmarks, including ePSI‐1, ePSI‐2, and ePSI‐3, were calculated by equation, ePSI=arccosA′pb*B′−∠α, and compared with the actual PSI (aPSI) measured by Surgamap software. For the reliability and validation evaluation, three observers measured these parameters in two rounds. Intra‐class correlation and inter‐class correlation were both calculated. Bland–Altman method was used to evaluate the consistency between the estimated PSI (ePSI) and the actual PSI (aPSI). Results ePSI‐1 and ePSI‐2 showed excellent intra‐observer reliability (0.921–0.997, p < 0.001) and inter‐observer reliability (0.801–0.977, p < 0.001). ePSI‐3 had a fair inter‐observer reliability (0.239–0.823, p < 0.001). ePSI‐1 showed the strongest correlation with aPSI (r = 0.917, p < 0.001). Mean (maximum) absolute difference of ePSI‐1, ePSI‐2, and ePSI‐3 is 2.62° (7.42°), 4.23° (13.78°), and 7.74° (31.47°), respectively. The proportion of cases with absolute difference less than 5° in three groups were 86.7% (ePSI‐1), 66.7% (ePSI‐2), 56.7% (ePSI‐3). Conclusion This new method based on inverse cosine function has good reliability and validity when used in the evaluation of PSI on pelvic anteroposterior radiographs. |
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| institution | Directory Open Access Journal |
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| language | English |
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| spelling | doaj.art-b6e23d1095e64490928a7c3f16c41fec2022-12-22T04:32:12ZengWileyOrthopaedic Surgery1757-78531757-78612022-10-0114102721272910.1111/os.13488Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior RadiographsHao‐han Huang0Yan Chen1Zhao‐xun Chen2Chang‐qing Zhao3Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaShanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai ChinaObjective Evaluation of sagittal pelvic tilt is significant for hip surgeons. However, the accurate measurement of pelvic sagittal inclination (PSI) is still a challenge. The objective of this study is to propose a new method for measurement of PSI from pelvic anteroposterior radiograph based on the inverse cosine function obtained from individualized pelvic model. Methods Collecting the imaging data of 30 patients with both pelvic CT and full‐length spine radiographs. Establishing pelvic model by customized 3D reconstruction software. The length of three groups of longitudinal and transverse line segments (A′p and B′) were measured from full‐length spine anteroposterior radiographs. The corresponding anatomical parameters, including A, B, b, ∠α, ∠γ, were measured and calculated on the same patient's pelvic model. The estimated PSI (ePSI) based on three groups of anatomical landmarks, including ePSI‐1, ePSI‐2, and ePSI‐3, were calculated by equation, ePSI=arccosA′pb*B′−∠α, and compared with the actual PSI (aPSI) measured by Surgamap software. For the reliability and validation evaluation, three observers measured these parameters in two rounds. Intra‐class correlation and inter‐class correlation were both calculated. Bland–Altman method was used to evaluate the consistency between the estimated PSI (ePSI) and the actual PSI (aPSI). Results ePSI‐1 and ePSI‐2 showed excellent intra‐observer reliability (0.921–0.997, p < 0.001) and inter‐observer reliability (0.801–0.977, p < 0.001). ePSI‐3 had a fair inter‐observer reliability (0.239–0.823, p < 0.001). ePSI‐1 showed the strongest correlation with aPSI (r = 0.917, p < 0.001). Mean (maximum) absolute difference of ePSI‐1, ePSI‐2, and ePSI‐3 is 2.62° (7.42°), 4.23° (13.78°), and 7.74° (31.47°), respectively. The proportion of cases with absolute difference less than 5° in three groups were 86.7% (ePSI‐1), 66.7% (ePSI‐2), 56.7% (ePSI‐3). Conclusion This new method based on inverse cosine function has good reliability and validity when used in the evaluation of PSI on pelvic anteroposterior radiographs.https://doi.org/10.1111/os.13488Anteroposterior radiographComputed tomographyPelvic sagittal inclinationTotal hip arthroplasty |
| spellingShingle | Hao‐han Huang Yan Chen Zhao‐xun Chen Chang‐qing Zhao Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs Orthopaedic Surgery Anteroposterior radiograph Computed tomography Pelvic sagittal inclination Total hip arthroplasty |
| title | Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs |
| title_full | Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs |
| title_fullStr | Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs |
| title_full_unstemmed | Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs |
| title_short | Reliability and Validity Analysis of Pelvic Sagittal Inclination Calculated by Inverse Cosine Function Method on Pelvic Anteroposterior Radiographs |
| title_sort | reliability and validity analysis of pelvic sagittal inclination calculated by inverse cosine function method on pelvic anteroposterior radiographs |
| topic | Anteroposterior radiograph Computed tomography Pelvic sagittal inclination Total hip arthroplasty |
| url | https://doi.org/10.1111/os.13488 |
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