Reliable angle assessment during periacetabular osteotomy with a novel device.

Abstract

We developed and assessed a measuring device for intraoperative assessment of the acetabular index and center edge angle during acetabular reorientation in periacetabular osteotomy. We asked whether reliable assessment of angles could be made using the device; to be reliable we presumed the variability of angle measurements should not exceed that of inherent variability when assessing angles on radiographs (+/- 5 degrees ). The device was mounted bilaterally on the pelvis, and using fluoroscopy, angle measurements were obtained with adjustable measuring discs. We conducted a cadaver study to assess intraobserver and interobserver variability of the device and to assess if pelvic positioning influenced variation of measurements. Intraoperative measurements of 35 consecutive patients were compared with measurements on postoperative radiographs. Intraoperatively obtained angle measurements differed less than +/- 5 degrees from measurements on postoperative radiographs and the intraobserver and interobserver variability of the device were confined within +/- 5 degrees . Positioning did not influence the variation of angle measurements beyond intraobserver variability of the device when applying arcs of tilt and rotation of +/- 12.5 degrees . We believe the device is a potentially helpful tool in the periacetabular osteotomy. It is simple to use and facilitates repeated reliable angle measurements during acetabular reorientation, making intraoperative radiographs unnecessary.