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Hardwick-Morris M, Wigmore E, Twiggs J, Miles B, Jones CW, Yates PJ. Leg length discrepancy assessment in total hip arthroplasty: is a pelvic radiograph sufficient? Bone Jt Open 2022; 3:960-968. [PMID: 36510730 PMCID: PMC9783271 DOI: 10.1302/2633-1462.312.bjo-2022-0146.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS Leg length discrepancy (LLD) is a common pre- and postoperative issue in total hip arthroplasty (THA) patients. The conventional technique for measuring LLD has historically been on a non-weightbearing anteroposterior pelvic radiograph; however, this does not capture many potential sources of LLD. The aim of this study was to determine if long-limb EOS radiology can provide a more reproducible and holistic measurement of LLD. METHODS In all, 93 patients who underwent a THA received a standardized preoperative EOS scan, anteroposterior (AP) radiograph, and clinical LLD assessment. Overall, 13 measurements were taken along both anatomical and functional axes and measured twice by an orthopaedic fellow and surgical planning engineer to calculate intraoperator reproducibility and correlations between measurements. RESULTS Strong correlations were observed for all EOS measurements (rs > 0.9). The strongest correlation with AP radiograph (inter-teardrop line) was observed for functional-ASIS-to-floor (functional) (rs = 0.57), much weaker than the correlations between EOS measurements. ASIS-to-ankle measurements exhibited a high correlation to other linear measurements and the highest ICC (rs = 0.97). Using anterior superior iliac spine (ASIS)-to-ankle, 33% of patients had an absolute LLD of greater than 10 mm, which was statistically different from the inter-teardrop LLD measurement (p < 0.005). DISCUSSION We found that the conventional measurement of LLD on AP pelvic radiograph does not correlate well with long leg measurements and may not provide a true appreciation of LLD. ASIS-to-ankle demonstrated improved detection of potential LLD than other EOS and radiograph measurements. Full length, functional imaging methods may become the new gold standard to measure LLD.Cite this article: Bone Jt Open 2022;3(12):960-968.
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Affiliation(s)
- Max Hardwick-Morris
- 360 Med Care, Sydney, NSW, Australia,Flinders University, Adelaide, SA, Australia,Correspondence should be sent to Max Hardwick-Morris. E-mail:
| | - Estelle Wigmore
- 360 Med Care, Sydney, NSW, Australia,Flinders University, Adelaide, SA, Australia
| | | | | | - Christopher W. Jones
- Curtin University Faculty of Health Sciences, School of Medicine, Perth, WA, Australia,Orthopaedics WA, Murdoch, WA, Australia,Fiona Stanley Hospital, Murdoch, WA, Australia,St. John of God Murdoch Hospital, Murdoch, WA, Australia,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia
| | - Piers J. Yates
- Orthopaedics WA, Murdoch, WA, Australia,Fiona Stanley Hospital, Murdoch, WA, Australia,St. John of God Murdoch Hospital, Murdoch, WA, Australia,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia,University of Western Australia, Faculty of Medicine, Dentistry and Health Sciences, Perth, WA, Australia
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Reus LM, Shen X, Gibson J, Wigmore E, Ligthart L, Adams MJ, Davies G, Cox SR, Hagenaars SP, Bastin ME, Deary IJ, Whalley HC, McIntosh AM. Association of polygenic risk for major psychiatric illness with subcortical volumes and white matter integrity in UK Biobank. Sci Rep 2017; 7:42140. [PMID: 28186152 PMCID: PMC5301496 DOI: 10.1038/srep42140] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/03/2017] [Indexed: 12/11/2022] Open
Abstract
Major depressive disorder (MDD), schizophrenia (SCZ) and bipolar disorder (BP) are common, disabling and heritable psychiatric diseases with a complex overlapping polygenic architecture. Individuals with these disorders, as well as their unaffected relatives, show widespread structural differences in corticostriatal and limbic networks. Structural variation in many of these brain regions is also heritable and polygenic but whether their genetic architecture overlaps with that of major psychiatric disorders is unknown. We sought to address this issue by examining the impact of polygenic risk of MDD, SCZ, and BP on subcortical brain volumes and white matter (WM) microstructure in a large single sample of neuroimaging data; the UK Biobank Imaging study. The first release of UK Biobank imaging data comprised participants with overlapping genetic data and subcortical volumes (N = 978) and WM measures (N = 816). The calculation of polygenic risk scores was based on genome-wide association study results generated by the Psychiatric Genomics Consortium. Our findings indicated no statistically significant associations between either subcortical volumes or WM microstructure, and polygenic risk for MDD, SCZ or BP. These findings suggest that subcortical brain volumes and WM microstructure may not be closely linked to the genetic mechanisms of major psychiatric disorders.
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Affiliation(s)
- L. M. Reus
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - X. Shen
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - J. Gibson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - E. Wigmore
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - L. Ligthart
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - M. J. Adams
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - G. Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - S. R. Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - S. P. Hagenaars
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - M. E. Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - I. J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - H. C. Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
| | - A. M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, United Kingdom
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
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Wigmore E. The War and British Medical Libraries. Bull Med Libr Assoc 1946; 34:151-66. [PMID: 16016727 PMCID: PMC194591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- E Wigmore
- Medical Research Council Library, Hampstead, London, N.W. 3
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