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  • Femoral anteversion: summary of replies

    Dear biomch-l subscribers

    a while ago I posted a question about the measurement of femoral
    anteversion from CT and conventional X-ray scans. Thanks to all who
    replied. Below you will find my original question followed by a summary
    of the responses I got.

    Thanks again.

    Francesco La Palombara

    -----------------------------------------------------------------------
    Francesco La Palombara

    Istituti Ortopedici Rizzoli Tel: +39.(0)51.636 6520
    Lab. di Biomeccanica Fax: +39.(0)51.583789

    via di Barbiano 1/10 E-mail: biomec@bo.nettuno.it
    I-40136 Bologna (please use "To Franz" as subject)

    Italy http://www.geocities.com/CapeCanaveral/Lab/1717/
    -----------------------------------------------------------------------



    ************************************************** *********************
    ORIGINAL POSTING:

    I am looking for a reliable and accurate manual or
    computer-assisted technique for measuring femoral anteversion using data
    deriving from CT and/or conventional X-ray scans.

    I am particularly interested in methods which have been validated
    through comparison with intraoperative or post-mortem direct
    measurements. I would also like to know where to retrieve information on
    normal and pathological value ranges for this parameter. One more
    question: does anybody have the complete reference to the paper(s) in
    which Reikerås proposes his approach?

    ************************************************** *********************


    SUMMARY OF REPLIES:

    Dr Georg Bergman and his collaborators at the Biomechanics
    Laboratory of the Orthopaedic Hospital of the Free University of Berlin
    Oskar-Helene-Heim (Clayallee 229, 14195 Berlin, Germany, Tel: +49 30
    81004 273, Fax: +49 30 81004 275, E-mail: bergmann@medizin.fu-berlin.de,
    WWW: http://www.medizin.fu-berlin.de/biomechanik) have developed a
    computer-assisted technique for the evaluation of ultrasound
    measurements, featuring a reproducibility of about 3 degrees. They are
    now validating the technique through clinical trials.

    Dr Patrick Costigan of the School of Physical and Health Education
    at Queen's University (Kingston, Ontario, Canada, Tel: ++613 545 6603
    E-mail: 3pac13@post.queensu.ca) developed a method for computing femoral
    anteversion from two X-ray views as part of his PhD thesis. Here is an
    overview of his method:

    ------------------------------------------------------------------------
    The method involves taking two x-rays; one is an AP view of the hip
    while the other is the AP view rotated by 30 degrees about the long
    axis. This method was developed using dry bones as test specimens. The
    actual anteversion angle was also measured directly with a 3D digitizer
    and with measurements from CT images. The data for dry bones follows:

    The anteversion angle measured by three methods.

    Bone Direct CT X-ray
    A76 0.6 0.5 11.0
    AD58 -4.6 0.0 10.3
    S100 20.4 22.3 23.7
    S104 19.5 24.8 19.4
    S105 -8.3 -5.0 7.5
    S162 0.1 4.0 15.2
    S175 -25.4 -14.5 0.2
    S192 10.6 7.3 14.1
    S212 2.0 -2.0 6.6
    S237 18.8 20.5 26.1
    S244 -2.4 18.8 19.0
    S250 2.3 1.5 11.7
    S262 22.4 26.8 28.4
    S269 25.6 22.3 26.9
    S316 12.9 16.0 18.4
    S338 10.3 20.8 21.4
    S341 11.8 18.5 21.1
    S342 5.0 8.0 13.6
    S346 19.2 23.0 23.7
    S8 -10.4 -7.0 4.5
    S89 12.3 15.0 15.9
    XYZ 0.5 3.8 13.9

    Using a regression procedure I developed regression equations to predict
    both the direct and CT measurements from the x-ray measurement. The
    resulting equations were:

    Direct = -17.5 + (1.50 * radiographic) r2=0.82 S.E.E. = 5.51
    CT = -14.0 + (1.51 * radiographic) r2=0.92 S.E.E. = 3.55

    The Standard Error of The Estimate (SEE) is the standard deviation of
    the
    differences between the actual measures (either direct or CT) and the
    respective predicted measure (the mean is approximately zero).
    ------------------------------------------------------------------------


    Dr Dieter Rosenbaum of the Kinesiology Lab at the Klinik und
    Poliklinik fuer Allgemeine Orthopaedie of the Westfaelische
    Wilhelms-Universitaet Muenster (Albert-Schweitzer-Str. 33, D-48129
    Muenster, Germany, Tel: +49 251 834 7981/7995, Fax: +49 251 834 7989,
    E-mail: diro@uni-muenster.de) suggested to contact Martin Simnacher and
    Peter Keppler at the University of Ulm, who developed a technique based
    on ultrasound measurements. Their E-mail address is
    simnach@sirius.medizin.uni-ulm.de

    Leonard D'Addesi of the Human Performance Laboratory at Thomas
    Jefferson University (130 South 9th Street, Suite 830, Philadelphia, PA
    19107-5233, USA, E-mail: sg943dvw@dunx1.ocs.drexel.edu) is completing
    his MS thesis on the assessment of femoral anteversion using motion
    analysis. He sent a large list of references which you can find below.

    ------------------------------------------------------------------------
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    ------------------------------------------------------------------------


    Christoph Roth of the Orthopaedic Research Institute, Inc. (E-mail:
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    ------------------------------------------------------------------------
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    ------------------------------------------------------------------------
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