Karlin et al: In Vitro Evaluation of a Device to Assess Acetabular Cup Position by Sagittal Plane Radiography
Veterinary and Comparative Orthopaedics and Traumatology 2, 2026

In Vitro Evaluation of a Device to Assess Acetabular Cup Position by Sagittal Plane Radiography

🔍 Key Findings

  • CPAD accurately measured angle of lateral opening (ALO) on sagittal radiographs with near-perfect agreement (Lin’s Rc = 0.994) compared with known angles.
  • No significant difference between measured and true ALO values was detected (p = 0.655), supporting accuracy of the device for this parameter.
  • Mean ALO measurement error was only 0.14° ± 1.18°, indicating high precision of the CPAD method.
  • Open-face version measurements were significantly inaccurate compared with known values (p < 0.0001).
  • Mean error in version measurement was 9.5° ± 6.31°, showing only moderate agreement (Rc = 0.424).
  • Measurement error in version likely resulted from radiographic superimposition of the V-axis bar with the cup edge, making bar endpoints difficult to identify.
  • CPAD accuracy for ALO (~1.18°) is nearly five times better than previous radiographic techniques, which typically achieve ~5° accuracy.
  • Intraoperative fluoroscopic use of CPAD may allow real-time adjustment of cup orientation, potentially reducing luxation risk after canine THA.

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Karlin et al: In Vitro Evaluation of a Device to Assess Acetabular Cup Position by Sagittal Plane Radiography
Veterinary and Comparative Orthopaedics and Traumatology 2, 2026

🔍 Key Findings

  • CPAD accurately measured angle of lateral opening (ALO) on sagittal radiographs with near-perfect agreement (Lin’s Rc = 0.994) compared with known angles.
  • No significant difference between measured and true ALO values was detected (p = 0.655), supporting accuracy of the device for this parameter.
  • Mean ALO measurement error was only 0.14° ± 1.18°, indicating high precision of the CPAD method.
  • Open-face version measurements were significantly inaccurate compared with known values (p < 0.0001).
  • Mean error in version measurement was 9.5° ± 6.31°, showing only moderate agreement (Rc = 0.424).
  • Measurement error in version likely resulted from radiographic superimposition of the V-axis bar with the cup edge, making bar endpoints difficult to identify.
  • CPAD accuracy for ALO (~1.18°) is nearly five times better than previous radiographic techniques, which typically achieve ~5° accuracy.
  • Intraoperative fluoroscopic use of CPAD may allow real-time adjustment of cup orientation, potentially reducing luxation risk after canine THA.

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Multiple Choice Questions on this study

In Karlin 2026 et al., on acetabular cup radiography, what was the primary reason proposed for poor accuracy in open-face version measurement using the CPAD?

A. Radiographic magnification error
B. Superimposition of the V-axis bar with the cup rim
C. Inaccurate calibration ball placement
D. Pelvic rotation during imaging
E. Incorrect bar length manufacturing

Answer: Superimposition of the V-axis bar with the cup rim

Explanation: The authors reported that the version bar was difficult to measure due to overlap with the titanium cup edge, reducing measurement accuracy.
In Karlin 2026 et al., on acetabular cup radiography, how does CPAD accuracy for measuring ALO compare with previously described radiographic methods?

A. Similar accuracy within 10 degrees
B. Slightly worse accuracy within 7 degrees
C. Approximately equal accuracy within 5 degrees
D. Approximately five times greater accuracy
E. Accuracy only improved for extreme ALO angles

Answer: Approximately five times greater accuracy

Explanation: Previous techniques achieved roughly 5° accuracy, while CPAD achieved ~1.18° accuracy, making it nearly five times more precise.
In Karlin 2026 et al., on acetabular cup radiography, which measurement showed significant inaccuracy when calculated using the CPAD?

A. Angle of lateral opening
B. Open-face version
C. Acetabular diameter
D. Pelvic tilt angle
E. Femoral neck angle

Answer: Open-face version

Explanation: The calculated open-face version differed significantly from the known value (p < 0.0001) and had only moderate correlation (Rc = 0.424).
In Karlin 2026 et al., on acetabular cup radiography, what was the approximate mean measurement error when calculating ALO using the CPAD?

A. 0.14 degrees
B. 2.5 degrees
C. 5 degrees
D. 9.5 degrees
E. 15 degrees

Answer: 0.14 degrees

Explanation: The study reported a mean difference between measured and known ALO of 0.14°, demonstrating high measurement accuracy.
In Karlin 2026 et al., on acetabular cup radiography, which parameter measured using the cup position assessment device (CPAD) demonstrated near-perfect agreement with the known value?

A. Angle of lateral opening (ALO)
B. Femoral stem anteversion
C. Acetabular cup diameter
D. Truncated-face inclination
E. Combined hip offset

Answer: Angle of lateral opening (ALO)

Explanation: The study found that CPAD measurement of ALO had near-perfect correlation with known values (Lin’s Rc = 0.994) and no significant difference statistically.

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