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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 2, 258-263.
doi: 10.1302/0301-620X.90B2.19950  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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The use of ultrasound in acquisition of the anterior pelvic plane in computer-assisted total hip replacement

A CADAVER STUDY

S. Parratte, MD, Arthroplasty Fellow1; P. Kilian, PhD, Biomechanical Engineer3; V. Pauly, MS, Statistician2; P. Champsaur, MD, PhD, Professor of Radiology and Anatomy4; and J.-N. A. Argenson, MD, PhD, Professor and Chairman of Orthopaedic Surgery1

1 Department of Orthopaedic Surgery
2 Department of Statistics Hospital Sainte-Marguerite 270, Bd Sainte Marguerite, 13009 Marseille, France.
3 Department of Imaging Research, Superior Engineering School of Luminy, 13009 Marseille, France.
4 Laboratory of Human Anatomy, Timone University, Bd Jean Moulin, 13005 Marseille, France.

Correspondence should be sent to Dr J.-N. A. Argenson; e-mail: jean-noel.argenson{at}ap-hm.fr

We have evaluated in vitro the accuracy of percutaneous and ultrasound registration as measured in terms of errors in rotation and version relative to the bony anterior pelvic plane in computer-assisted total hip replacement, and analysed the intra- and inter-observer reliability of manual or ultrasound registration.

Four clinicians were asked to perform registration of the landmarks of the anterior pelvic plane on two cadavers. Registration was performed under four different conditions of acquisition. Errors in rotation were not significant. Version errors were significant with percutaneous methods (16.2°; p < 0.001 and 19.25° with surgical draping; p < 0.001), but not with the ultrasound acquisition (6.2°, p = 0.13). Intra-observer repeatability was achieved for all the methods. Inter-observer analysis showed acceptable agreement in the sagittal but not in the frontal plane.

Ultrasound acquisition of the anterior pelvic plane was more reliable in vitro than the cutaneous digitisation currently used.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General