International Orthopaedics

, Volume 42, Issue 12, pp 2777–2785 | Cite as

Accuracy of plain antero-posterior radiographic-based methods for measurement of acetabular cup version

  • Mohammad Ali Alzohiry
  • Mohammad Kamal AbdelnasserEmail author
  • Mohamed Moustafa
  • Mohamed Mahran
  • Hatem Bakr
  • Yaser Khalifa
  • Ahmed Abelaal
  • Haisam Atta
  • Galal Zaki Said
Original Paper



Acetabular cup version is crucial for successful total hip arthroplasty (THA). Many methods have been described for measurement of cup version angle. The aim of this study is to assess the accuracy of five commonly used methods for measurement of acetabular cup version in plain antero-posterior views of the pelvis and hip.

Material and methods

Sixty primary THA cases were subjected postoperatively to plain A-P of the pelvis (AP-P), A-P view of the hip (AP-H), and computed tomography (CT) imaging. The acetabular cup version was measured in AP-P and AP-H by five methods (Lewinnek, Widmer, Hassan et al., Ackland et al., and Liaw et al.). These measurements were compared to the CT measurement.


All plain X-ray methods showed no significant differences from the CT, except those of Hassan et al. in AP-H, and Widmer and Ackland et al. in AP-P.

Conclusions and recommendations

For measurement of acetabular cup version angle, we recommend the use of Lewinnek and Liaw et al. methods both in AP-P and in AP-H, while Hassan et al.’s method is recommended in AP-P only, and Widmer and Ackland et al.’s methods in AP-H only.


Total hip arthroplasty (THA) Acetabular cup version Antero-posterior view of the pelvis (AP-P) Antero-posterior view of the hip (AP-H) Computed tomography (CT) 


Compliance with ethical standards

This study was approved by the institutional review board (ethical committee) of our institution. Informed consent was obtained from the patients following the guidelines set forth by our institution and by the Declaration of Helsinki and Good Clinical Practice. The consent included approval of the patients to undergo post-operative CT.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Mohammad Ali Alzohiry
    • 1
  • Mohammad Kamal Abdelnasser
    • 1
    Email author
  • Mohamed Moustafa
    • 1
  • Mohamed Mahran
    • 1
  • Hatem Bakr
    • 1
  • Yaser Khalifa
    • 1
  • Ahmed Abelaal
    • 1
  • Haisam Atta
    • 2
  • Galal Zaki Said
    • 1
  1. 1.Orthopedic DepartmentAssiut University HospitalAssiutEgypt
  2. 2.Radiology Department, South Egypt Cancer InstituteAssiut UniversityAssiutEgypt

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