J Korean Orthop Assoc.  2009 Aug;44(4):408-413.

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

• Han KY
• Cho SG

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 45degrees 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 45degrees 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 45.3degrees in men and 48.1degrees 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 45degrees is done without considering the pelvic tilt inclination at the lateral decubitus position, then the inclination angle could be lower than expected.

Keyword

Hip; Total hip arthroplasty; Inclination angle; Lateral decubitus position; Goniometer

MeSH Terms

Acetabulum
Adult
Arthroplasty
Body Mass Index
Female
Hip
Hip Joint
Humans
Male
Orientation
Pelvis
Shoulder

Figure

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  Fig. 1 Simple goniometer with long indicator targeted to 45° for measuring the pelvic tilt.

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  Fig. 2 The photograph of the anteroposterior radiograph imaging technique in lateral decubitus position using goniometer.

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  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.

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