Deviation of Latitude Cut: A Simple Sign to Differentiate Total Hip Arthroplasty from Hemiarthroplasty in Radiography

This study aims to propose latitude cut deviation for differentiating hip arthroplasty types and evaluate its diagnostic utility in distinguishing total hip arthroplasty (THA) from hemiarthroplasty using radiography. After assessing various cup designs from top manufacturers for THA and hemiarthroplasty, we conducted a retrospective study on 40 patients (20 THA and 20 hemiarthroplasty). Three readers independently evaluated the radiographs, assessing acetabular sparing, cup-bone interface texture, and latitude cut deviation. Diagnostic performance and inter-observer agreement were compared using receiver operating characteristic curves and the Fleiss kappa coefficient. Latitude cut deviation measured on implant designs ranged from 19% to 42% in hemiarthroplasty and from -12% to 9% in THA. The sensitivity, specificity, and accuracy used to distinguish THA from hemiarthroplasty were 60-85%, 55-95%, and 62.5-77.5% for acetabular sparing; 100%, 50-80%, and 75-90% for cup-bone interface texture; and 100%, 90-100%, and 95-100% for latitude cut deviation. Inter-observer agreement for acetabular sparing, cup-bone interface texture, and latitude cut deviation ranged from moderate to excellent (kappa = 0.499, 0.772, and 0.900, respectively). The latitude cut deviation exhibited excellent diagnostic performance and inter-reader agreement in distinguishing hemiarthroplasty from THA on radiographs, offering a concise way to identify hip arthroplasty type.