Two-dimensional computed tomographic measurement of acetabulum--reliability, validity, and limitation.
BACKGROUND
The shape of the dysplastic acetabulum has been generally determined by 2-dimensional computed tomography (CT) measurements (transaxial CT indices), such as the anterior and posterior acetabular indices and acetabular anteversion. However, their reliability and validity in evaluating the acetabular coverage have not been confirmed.


METHODS
This study examined the reliability and validity of the transaxial CT indices using 2- and 3-dimensional CT analyses of the acetabulum before and after a Dega osteotomy. Twenty-two acetabuli from 16 patients with cerebral palsy with hip instability were examined. Interobserver and intraobserver reliability tests were performed, and the preoperative and postoperative measurements were compared for the concurrent and construct validity test.


RESULTS
The transaxial CT indices revealed substantial intraobserver and interobserver reliability. The concurrent validity of the anterior acetabular and posterior acetabular indices before osteotomy was moderate (r = 0.45, 0.49), whereas the construct validity after osteotomy was low when compared with 3-dimensional methods.


CONCLUSIONS
The transaxial CT indices are reliable and valid for assessing the acetabular coverage in the preoperative status. However, care should be taken when using these indices to assess the outcome of a pelvic-reshaping osteotomy because of their insufficient construct validity.


METHODS
Level III of diagnostic study.
Park
Moon Seok
MS
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea.
Chung
Chin Youb
CY
Lee
Sang Hyeong
SH
Cho
Tae-Joon
TJ
Yoo
Won Joon
WJ
Choi
In Ho
IH
D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000473:pathology; D002547:Cerebral Palsy / Q000150:complications / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D010027:Osteotomy / Q000379:methods; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*