Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study

Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study Hayato Suzuki, Norio Imai, Yuki Hirano, Naoto Endo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-24771/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background HipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, alignment accuracy in obese patients has not been examined. We aimed to compare the cup-alignment accuracy, using HipCOMPASS, between patients with and without obesity. Methods We retrospectively evaluated 448 consecutive patients who underwent primary THA using HipCOMPASS. We measured the soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis using preoperative computed tomography (CT) images and the difference in cup angle pre- and postoperatively based on the cup-alignment error on CT. We used Pearson coefficients to determine the correlation of body mass index (BMI) and soft-tissue thickness with cup-alignment error. We created receiver operating characteristic (ROC) curves to determine the cutoff value for statistically significant cup-alignment error factors in radiographic inclination and anteversion of ≥ 5°. Results There were significant correlations between the absolute value of radiographic anteversion difference and BMI ( r = 0.205), ASIS thickness ( r = 0.419), and pubic symphysis thickness ( r = 0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS ( r = 0.257) and pubic symphysis thickness ( r = 0.202). The ROC curve showed a pubic symphysis thickness of 37.2 mm for a ≥ 5° implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was ≥ 37.2 mm on preoperative CT. Conclusion We recommend using methods other than HipCOMPASS, including computed tomography-based navigation systems, in obese patients. Orthopedic Surgery HipCOMPASS total hip arthroplasty cup-alignment accuracy body mass index soft-tissue thickness Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background In total hip arthroplasty (THA), malalignment of implants reportedly leads to increased dislocation rates and polyethylene wear associated with impingement [ 1 , 2 ]. Therefore, accurate implantation is very important. In recent years, mechanical intraoperative support devices or navigation systems have been used to place implants accurately [ 3 , 4 ]. Previous studies have reported that dislocation after THA occurs more often in patients with obesity because accurate implantation of the acetabular component is difficult in these patients [ 5 , 6 ]. Barrack et al. [ 7 ] conducted a multivariate regression analysis of 1549 THA cases and found that a body mass index (BMI) ≥ 30 kg/m 2 increased the risk of malpositioning of the acetabular cup. They also found that the odds of malpositioning of the acetabular cup increased by ≥ 0.2 for each 5 kg/m 2 increase in BMI. To increase the accuracy of cup alignment, especially to reduce a cup-alignment error of < 5°, a mechanical intraoperative support device, HipCOMPASS [ 8 ], was developed in 2012. This is placed on the skin with the anterior-superior iliac spine (ASIS) and pubic symphysis (PS) as reference points. A previous study reported that the accuracy of cup radiographic inclination and radiographic anteversion, according to Murray’s definition [ 9 ], was more improved in the HipCOMPASS group compared to that in the group without HipCOMPASS, which used conventional non-navigation techniques [ 8 ]. However, another study encountered a high-extremity BMI case in which accurate cup implantation was difficult even when using HipCOMPASS at the developmental stage. Because this device is placed on the skin, there is a possibility that implantation may be impaired in patients with high soft-tissue thickness [ 8 ]. However, cup-alignment errors caused by BMI and soft-tissue thickness have not been examined. The purpose of this study was to clarify the errors of acetabular-cup positioning caused by BMI and soft-tissue thickness in THA using a mechanical intraoperative support device, HipCOMPASS. Moreover, we also aimed to calculate the cutoff for the error values of ≥ 5° for anteversion and inclination, because a previous study stated that the implantation error in radiographic anteversion and radiographic inclination were 2.9 ± 2.3° and 2.9 ± 2.1°, respectively, using HipCOMPASS [ 8 ], and the total value of the average and standard deviation was almost 5° for BMI and soft-tissue thickness on the ASIS and/or PS. Methods Participants From April 1, 2012 to March 31, 2017, HipCOMPASS (LEXI, Tokyo, Japan) was used in the supine position in 462 patients who underwent primary THA and had not undergone other hip surgeries before the THA. These participants were completely different from those of a previous report [ 8 ]. We excluded 14 cases; six that required an additional bulky bone graft for severe dysplasia and eight simultaneous bilateral procedures. Therefore, we included only cases where the ipsilateral side was prioritized because the setting of HipCOMPASS had a bilateral effect. Consequently, 448 consecutive cases were included in this study, and we evaluated them retrospectively. They underwent THAs with a purely cementless acetabular component, while the femoral component was cemented or cementless. All THAs were performed using the anterolateral supine approach. Seven senior orthopedic surgeons performed the procedure in these participants. We inserted the acetabular cup according to HipCOMPASS. After press-fit fixation of the acetabular cup, we routinely inserted 1–3 cancellous screws (AESCLUP, Tuttlingen, Germany) as an additional fixation. Plasmacup MSC or Plasmafit (AESCLUP, Tuttlingen, Germany), a hemispherical titanium plasma-sprayed cup, was used as the acetabular component. We conducted this study with approval from the ethics committee of the Niigata University Medical and Dental Hospital (No. 2019 − 0177), and it was performed in accordance with the Declaration of Helsinki. Since this was a retrospective study, informed consent was waived as the patient data were kept confidential. Mechanical intraoperative support device: HipCOMPASS HipCOMPASS consists of a T-plate with three legs of the same length and an angle indicator that can be installed on the plate (Fig. 1 ). The three legs can be slid over the plate, and the T-plate can be made parallel to the anterior pelvic plane (APP) by pressing each leg on both the ASIS and PS. However, this method causes error in the inclination of the T-plate and APP due to the difference in soft-tissue thickness between the ASIS and PS (Fig. 2 ). After anesthesia, both the ASIS and PS were punctured, and a special depth gauge (LEXI, Tokyo, Japan) was pressed into the tissue to measure the thickness of the soft tissue on both the ASIS and PS. The difference in soft-tissue thickness between average values of both the ASIS and PS was calculated. The error between the inclination of the APP and the T-plate were corrected by shortening the leg on the PS by the amount of difference. An angle indicator was adjusted to point to the angle that converted radiographic inclination and radiographic anteversion, planned relative to the functional pelvic plane, to the APP and was placed on the T-plate that was made parallel to the APP to indicate the planned cup-implantation angle. During the operation, the cup was placed at the planned angle by placing the cup holder and the indicator parallel to each other [ 9 ]. Preoperative planning Preoperative planning was performed using preoperative computed tomography (CT) data installed using ZedHip® three-dimensional (3D) THA planning software (Lexi, Tokyo, Japan). We set the cup radiographic inclination at 40° relative to the functional pelvic plane in all patients. The cup radiographic anteversion was adjusted in the range of 10–20°, mainly 15°, relative to the functional pelvic plane [ 10 ] considering the stem anteversion, according to the “combined anteversion theory” [ 11 , 12 ]. Measurements of the soft-tissue thickness If the cup-placement error increased, even with the use of HipCOMPASS, we had to prepare other methods for accurate cup implantation before the operation. In the above-mentioned method of measuring the soft-tissue thickness after anesthesia just before the surgery, other methods were not prepared. Therefore, we measured the soft-tissue thickness on both the ASIS and PS using preoperative CT images. We adjusted the 3D pelvis model according to the functional pelvic plane, the same as the preoperative planning plane stated above, and measured the length from the PS to the skin surface at a right angle to the PS as PS-thickness (Fig. 3 b). In a similar manner, we also measured the length from bilateral ASISs to the skin surface at a right angle to each ASIS, and the average value of the right and left length was expressed as ASIS-thickness (Fig. 3 a). The values of these soft-tissue thickness measurements using CT images were different from the soft-tissue thickness measured when HipCOMPASS was placed on the skin intraoperatively. Therefore, measurements obtained from CT images were not used for intraoperative adjustment of the leg using HipCOMPASS. Measurements of the alignment of the acetabular component The CT scans were examined in patients 1 week after THA for postoperative evaluation of the positioning of both the acetabular and femoral components using ZedHip® software (Lexi, Tokyo, Japan) [ 13 , 14 , 15 ]. The cup-placement angle was evaluated using the ZedHip postoperative evaluation system as described previously [ 16 ]. In this system, the contour of the 3D pelvic model, created from preoperative CT data, was automatically superimposed on a 3D pelvic model created from postoperative CT data, so that the postoperative cup radiographic inclination and anteversion relative to the preoperative functional pelvic plane could be determined. Thus, the errors between the preoperative planning and postoperative cup radiographic inclination and anteversion were calculated. Statistical analysis Statistical calculations were performed using SPSS statistical software (SPSS version 24, Inc., Chicago, IL, USA). The correlations between BMI and the differences in radiographic inclination and radiographic anteversion were evaluated using Pearson’s correlation coefficients. The unpaired Student’s t-test was performed to compare quantitative data, such as age and BMI. Multiple logistic regression analysis was conducted to determine which factor contributed to the presence of an implantation error ≥ 5° in radiographic inclination, radiographic anteversion, and both radiographic inclination and radiographic anteversion simultaneously. Moreover, we created receiver operating characteristic (ROC) curves to determine the cutoff values for statistically significant factor(s) of implantation error in radiographic inclination and radiographic anteversion of ≥ 5°, determined by multiple logistic regression analysis, for BMI and soft-tissue thickness on the ASIS and/or PS. We also calculated the area under the curve (AUC) from ROC curves, and cutoff values determined the point where the sensitivity + 1-specificity was maximum according to the Youden index [ 17 , 18 ]. Furthermore, we examined statistical power (type II (β) error) as a post-hoc analysis and a desirable power value of at least 0.8 [ 19 ]. We defined 0.5 as the effect size (d) and 0.05 as a type Ⅰ (α) error in the t-test and 0.3 as the effect size (d) and 0.05 as a type Ⅰ (α) error in the correlation analysis and multiple logistic regression analysis. We confirmed intraobserver reliability with intraclass correlation coefficients (ICCs), and two-sided 95% confidential intervals (CIs) were calculated to evaluate validations. One observer conducted two measurements with an interval of more than 1 week on 56 randomly selected patients. Furthermore, we compared the measurements to assess the interobserver reliability using a single measurement from two observers, using the same 56 patients as above. Statistical significance of the P -value was set at .05. Results In total, the 448 THAs in this study included 72 males and 376 females, with a mean age of 65.9 ± 10.6 years. Among them, 255 THAs were performed on the right side and 193 on the left side, and the mean BMI was 23.6 ± 4.0 kg/m 2 . Preoperative diagnoses were osteoarthritis of the hip in 388 cases, osteonecrosis of the femoral head in 42, hip fracture in 6, rapidly destructive arthropathy of the hip in 7, and rheumatoid arthritis in 5 patients. The average cup radiographic inclination was 41.0 ± 3.2°, and radiographic anteversion was 15.8 ± 3.5°. Radiographic inclination and radiographic anteversion differences in all participants were 1.5 ± 3.8° and 0.8 ± 3.7°, respectively, and the absolute values were 3.3 ± 2.4° and 3.1 ± 2.2°, respectively. Among the THA cases, 71.9% (322/448) were implanted within 5° of both the radiographic inclination and radiographic anteversion, and 4.7% (21/448) were implanted within ≥ 5° of both radiographic inclination and radiographic anteversion simultaneously (Fig. 4 ). There were significant correlations between absolute values of radiographic anteversion difference and BMI ( r = 0.205), ASIS-thickness ( r = 0.419), and PS-thickness ( r = 0.434). Absolute values of radiographic inclination difference were significantly correlated with ASIS-thickness ( r = 0.257) and PS-thickness ( r = 0.202) (Table 1 ). There were statistical differences in BMI, ASIS-thickness, and PS-thickness between patients whose implantation error was < 5° and those with a ≥ 5° error in radiographic inclination and radiographic anteversion (Table 2 ). Multiple logistic regression analysis was conducted with these parameters; ASIS-thickness was considered a significant independent risk factor of a ≥ 5° implantation error in radiographic inclination, and PS-thickness was considered a significant independent risk factor of a ≥ 5° implantation error in radiographic anteversion and in both radiographic anteversion and radiographic inclination simultaneously (Table 3 ). According to the ROC curve, an ASIS-thickness of 16.8 mm was considered the cutoff value for a ≥5° implantation error in radiographic inclination, while a PS-thickness of 35.0 mm was considered the cutoff value for a ≥5° implantation error in radiographic anteversion. Furthermore, a PS-thickness of 37.2 mm was considered the cutoff value for a ≥5° implantation error in both radiographic inclination and radiographic anteversion simultaneously (Fig. 5) (Table 4). Regarding the post-hoc analysis, power values were 0.99 for a ≥5° implantation error in radiographic inclination, 0.99 for a ≥5° implantation error in radiographic anteversion, and 0.72 for a ≥5° implantation error in both radiographic inclination and radiographic anteversion simultaneously according to the unpaired t-test. In terms of the correlation analysis and multiple logistic regression analysis, power values were 0.97 and 0.99, respectively. With regard to intraobserver validity, a high ICC of >0.9 was obtained for both intraobserver and interobserver reliabilities for each parameter (Table 5). No dislocation occurred during the follow-up period of 1 year in these 448 patients. Discussion In this study, BMI was associated with radiographic anteversion errors, while PS-thickness and ASIS-thickness were associated with both radiographic anteversion errors and radiographic inclination errors (Table 1 ). Furthermore, we found that PS-thickness and ASIS-thickness were independent risk factors for implantation error of the acetabular component in THA using HipCOMPASS. PS-thickness and ASIS-thickness were considered to be more precise influencing factors because they were more related owing to the installation error of HipCOMPASS. Tsukada et al. reported that errors of cup anteversion were larger in patients with a BMI ≥ 25 kg/m 2 than in others [ 20 ]. Similarly, Parratte et al. reported that cup anteversion, measured by postoperative CT, was significantly different from cup anteversion displayed intraoperatively on the navigation screen in patients with a BMI ≥ 27 kg/m 2 [ 21 ]. However, BMI alone did not give a cutoff value. It is thought that this is because body composition, such as muscle mass and fat mass, differs depending on the person, and the decrease in height due to poor posture affects the BMI. The decrease in height owing to poor posture may affect the progression of hip disease; it can significantly affect BMI, especially in patients undergoing THA. Malpositioning of the acetabular cup increases the risk of dislocation, wear of the bearing surface, and instability of components [ 1 , 22 , 23 , 24 , 25 ]. If the surgeons are able to identify patients whose acetabular components are likely to be malpositioned, they should pay special attention to the implantation. It is well-known that obesity is one of the risk factors of dislocation due to the malpositioning of the acetabular component [ 5 , 6 ]. It was previously reported that THA with a CT-based navigation system was not affected by obesity, even though patients’ BMIs were ≥ 30 kg/m 2 [ 16 ]. In the 448 consecutive cases in this study, no dislocation was observed during the 1-year follow-up period. However, Widmer et al. [ 11 ] confirmed that the optimal cup-positioning angle to reduce the risk of dislocation was 40–42° of radiographic inclination and 20–28° of radiographic anteversion relative to the APP for considering maximum range of motion (ROM) by using 3D computer simulation. Further age-related changes in the spinal-pelvis alignment over time [ 26 , 27 ] may lead to later instances of dislocation. This study has several limitations. First, this was a retrospective study with a small sample size. Second, the power value of a ≥ 5° implantation error in both radiographic inclination and radiographic anteversion simultaneously was 0.72 according to the unpaired t-test while a desirable power value was at least 0.8. However, we could evaluate the soft-tissue thickness with high reliability with a high ICC value of > 0.9, similar to previous studies [ 9 , 16 , 28 , 29 , 30 ]. Moreover, according to our findings, the surgeons could predict the risk of a ≥ 5° implantation error by the CT images taken before surgery. We are convinced that this is a strong point of the current study. Third, HipCOMPASS itself has several limitations. HipCOMPASS is an alignment guide and has the disadvantage of not being able to guide the location of implantation, which can be performed using CT-based navigation systems. Additionally, HipCOMPASS can be used only for THA in the supine position and cannot be used in the lateral decubitus position. However, HipCOMPASS has the advantage of being inexpensive compared to CT-based navigation systems. The accuracy of cup alignment placed using HipCOMPASS was approximately 3° (Suda et al., 2016); it is slightly inferior to the accuracy of 2° obtained by CT-based navigation systems (Imai et al., 2019); although, it is sufficiently acceptable. In this study, we showed that the cup-alignment error tends to be large, especially in patients with a large PS-thickness, when HipCOMPASS is used in THA. Therefore, we recommend the use of other methods, such as CT-based navigation systems, in cases of a PS-thickness ≥ 37.2 mm on preoperative CT images, because a ≥ 5° implantation error is likely to occur in both radiographic inclination and radiographic anteversion simultaneously. Abbreviations APP: anterior pelvic plane ASIS: anterior-superior iliac spine AUC: area under the curve BMI: body mass index CI: confidence interval CT: computed tomography ICC: intraclass correlation coefficient PS; pubic symphysis ROC: receiver operating characteristic THA; total hip arthroplasty Declarations Ethics approval and consent to participate The study was approved by the ethics committee of the Niigata University Medical and Dental Hospital (No. 2019-0177). Since this was a retrospective study, informed consent was waived as the patient data were kept confidential. Consent for publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare no conflict of interest. Funding No funding was received for this study. Authors’ contributions HS and NI contributed to study conception, design and drafting of manuscript. YH and HS were involved in acquisition, analysis and interpretation of data. NE critically revised the data. All authors read and approved the final manuscript. Acknowledgements The authors would like to thank Editage (www.editage.com) for English language editing. References Kennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty. 1998;13:530–4. Tian JL, Sun L, Hu RY, Han W, Tian XB. Correlation of cup inclination angle with liner wear for metal-on-polyethylene in hip primary arthroplasty. Orthop Surg. 2017;9:186–90. Iwana D, Nakamura N, Miki H, Kitada M, Hananouchi T, Sugano N. Accuracy of angle and position of the cup using computed tomography-based navigation system in total hip arthroplasty. Comput Aided Surg. 2013;18:187–94. Fujihara Y, Fukunishi S, Fukui T, Nishio S, Okahisa S, Takeda Y, et al. 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Evaluation of anatomical pelvic parameters between normal, healthy men and women using three-dimensional computed tomography: a cross-sectional study of sex-specific and age-specific differences. J Orthop Surg Res. 2019;14:126. Tables Table 1. Correlation between BMI, ASIS-thickness, PS-thickness, and THA acetabular cup radiographic inclination difference and radiographic anteversion difference with the HipCOMPASS system BMI (kg/m 2 ) ASIS-thickness (mm) PS-thickness (mm) Radiographic inclination difference (°) 0.110 (.240) 0.257 (<.001) 0.202 (<.001) Radiographic anteversion difference (°) 0.205 (<.001) 0.419 (<.001) 0.434 (<.001) Data are expressed as correlation coefficient ( P -value) BMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty. Table 2. Univariate analysis of BMI, ASIS-thickness, and PS-thickness between the patients whose THA acetabular cup-implantation errors with the HipCOMPASS system were <5° and those that were ≥5° in acetabular cup radiographic inclination and radiographic anteversion Radiographic inclination difference <5° Radiographic inclination difference ≥5° P -value Number 322 116 BMI (kg/m 2 ) 23.5 ± 3.7 24.7 ± 4.3 .017 ASIS-thickness (mm) 17.4 ± 11.8 24.2 ± 15.6 <.001 PS-thickness (mm) 30.0 ± 11.0 35.0 ± 13.2 .001 Radiographic anteversion difference <5° Radiographic anteversion difference ≥5° P -value Number 347 101 BMI (kg/m 2 ) 23.4 ± 3.6 25.0 ± 4.3 <.001 ASIS-thickness (mm) 15.9 ± 10.1 28.3 ± 16.3 <.001 PS-thickness (mm) 28.4 ± 9.6 39.6 ± 13.6 <.001 At least radiographic inclination or radiographic anteversion difference <5° Both radiographic inclination and radiographic anteversion difference ≥5° P -value Number 427 21 BMI (kg/m 2 ) 23.6 ± 3.8 24.9 ± 4.9 .045 ASIS-thickness (mm) 17.9 ± 12.1 34.6 ± 17.2 <.001 PS-thickness (mm) 30.2 ± 11.0 44.9 ± 14.1 <.001 Continuous values are expressed as average ± standard deviation BMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty. Table 3. Multiple logistic regression analysis of BMI, ASIS-thickness, and PS-thickness between the patients whose THA acetabular cup-implantation errors with the HipCOMPASS system were <5° and those that were ≥5° in radiographic inclination and radiographic anteversion Odds ratio P -value 95% CI radiographic inclination difference ≥5° BMI (kg/m 2 ) 0.985 .439 0.899-1.080 ASIS-thickness (mm) 1.045 .002 1.002-1.090 PS-thickness (mm) 0.992 .077 0.944-1.039 radiographic anteversion difference ≥5° BMI (kg/m 2 ) 0.847 .754 0.762-1.043 ASIS-thickness (mm) 1.039 .076 0.996-1.084 PS-thickness (mm) 1.085 .039 1.030-1.143 Both radiographic inclination and radiographic anteversion difference ≥5° BMI (kg/m 2 ) 0.913 .300 0.768-1.085 ASIS-thickness (mm) 1.024 .146 0.962-1.091 PS-thickness (mm) 1.067 <.001 1.038-1.097 BMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty; CI, confidence interval. Table 4. Area under curve and cutoff values by receiver operating characteristic curves Implantation error Factor AUC Cutoff value (mm) Sensitivity 1-Specificity 95% CI P -value ≥5° in radiographic inclination ASIS-thickness 0.645 16.8 0.643 0.390 0.573-0.718 <.001 ≥5° in radiographic anteversion PS-thickness 0.756 35.0 0.693 0.186 0.684-0.818 <.001 ≥5° in both radiographic inclination and radiographic anteversion simultaneously PS-thickness 0.808 37.2 0.833 0.248 0.703-0.913 <.001 ASIS-thickness, anterior-superior iliac spine thickness; AUC, area under the cureve; PS-thickness, pubic symphysis; CI, confidence interval. Table 5. Intra- and interobserver reliabilities Intraobserver reliability Interobserver reliability MAD ± SD ICC MAD ± SD ICC Radiographic inclination 0.59 ± 0.71 0.972 0.66 ± 0.73 0.952 Radiographic anteversion 0.68 ± 0.72 0.962 1.07 ± 1.11 0.932 ASIS-thickness 0.50 ± 0.43 0.999 0.88 ± 0.78 0.999 PS-thickness 0.53 ± 0.45 0.999 0.73 ± 0.52 0.999 MAD, mean absolute difference; SD, standard deviation; ASIS-thickness: soft-tissue thickness of anterior superior iliac spine, PS-thickness: soft-tissue thickness of pubic symphysis. All ICCs had a P-value < 0.05. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-24771","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":526892,"identity":"c7752068-aa01-4c49-9826-1b04e9210770","order_by":1,"name":"Hayato Suzuki","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABJ0lEQVRIie2QP0vDQBiH33LQOFTj+IYO/QoXDtIKQr/KhUCyZBNKJg0occkHSL5FISCOVwqdDrJmrEumDgVButnLYC1yVdwE7xmO43c89/4BMBj+IPToToAnSGyA/kfCTyrioMiJ5aS/UnoPiU3Fp6JlbEn3dZvAlNaS0ZcUh6wJ2rVKRqrDdq1RrvKYoZDgz4Vk3H9G5jXh2C0kuGUKEdUoVMQUFxlwusiZ8CUGXsO94XmXCAhRp9QbtlPKlC4HSsnwriqit++VJva6Kr35aqAay5BQjH+o0rSziVSzlLJ/Q7lEgnIzcwqJbnl/YpY6qJpEbeyiXlbOLrkl9mP0hNvkemRbeajbGMBZ99P7UXDJu1O1RAah1gDr60+2ODyt9IrBYDD8M/YdemVbdw4wXAAAAABJRU5ErkJggg==","orcid":"","institution":"Niigata University Graduate School of Medical and Dental Sciences","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Hayato","middleName":"","lastName":"Suzuki","suffix":""},{"id":526893,"identity":"46a33f76-1ea8-4ed5-acce-f4b83651285f","order_by":2,"name":"Norio Imai","email":"","orcid":"","institution":"Niigata University Graduate school of Medical and Dental Science","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Norio","middleName":"","lastName":"Imai","suffix":""},{"id":526894,"identity":"beb9cbef-237a-47a0-9fc7-507fd02fd7d8","order_by":3,"name":"Yuki Hirano","email":"","orcid":"","institution":"Niigata University Graduate School of Medical and Dental Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yuki","middleName":"","lastName":"Hirano","suffix":""},{"id":526895,"identity":"1eb2231e-03f2-4e67-afc9-180c7a68203c","order_by":4,"name":"Naoto Endo","email":"","orcid":"","institution":"Niigata University Graduate school of Medical and Dental Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Naoto","middleName":"","lastName":"Endo","suffix":""}],"badges":[],"createdAt":"2020-04-23 17:17:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-24771/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-24771/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":1028499,"identity":"442676cb-a9de-4aec-9cfd-baded3c7b080","added_by":"auto","created_at":"2020-05-04 20:29:06","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":2117967,"visible":true,"origin":"","legend":"Placement of HipCOMPASS legs.\nTwo legs placed on both ASISs (leg A and B) are hollow for fixation inserting K-wires. The length of the leg on the PS can be changed.\nASIS, anterior-superior iliac spine; APP, anterior pelvic plate; PS, pelvic symphysis","description":"","filename":"Fig1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/Fig1.jpg"},{"id":1028500,"identity":"3f149f35-3337-4a76-a9ed-1f46fadf2006","added_by":"auto","created_at":"2020-05-04 20:29:06","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":335506,"visible":true,"origin":"","legend":"APP comparison.\na: ASIS, b: PS, c: APP on the skin, d: true APP, e: difference between soft-tissue thickness on the ASIS and on the PS.\nASIS, anterior-superior iliac spine; APP, anterior pelvic plate; PS, pelvic symphysis","description":"","filename":"Fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/Fig2.jpg"},{"id":1028501,"identity":"f87f7b61-f53e-4118-85f9-04c54d53568d","added_by":"auto","created_at":"2020-05-04 20:29:06","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":435273,"visible":true,"origin":"","legend":"CT images adjusted to functional pelvic plane.\na Measurement of ASIS-thicknesses, b Measurement of PS-thicknesses\n1: ASIS-thickness on right side, 2: ASIS-thickness on left side, 3: PS-thickness\nASIS, anterior-superior iliac spine; PS, pelvic symphysis; CT, computed tomography","description":"","filename":"Fig3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/Fig3.jpg"},{"id":1028502,"identity":"833076fa-dc10-4248-84dd-0dfa66bcf9ad","added_by":"auto","created_at":"2020-05-04 20:29:06","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":499949,"visible":true,"origin":"","legend":"HipCOMPASS cup-implantation errors. \nOf the total THA cases, 71.9% are implanted within 5° of both radiographic inclination and anteversion, and 4.7% are implanted with a ≥5° error in radiographic inclination and anteversion simultaneously.\nTHA, total hip arthroplasty","description":"","filename":"Fig4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/Fig4.jpg"},{"id":1028503,"identity":"f157c02d-bacf-47a1-a346-c3ce8b8bf843","added_by":"auto","created_at":"2020-05-04 20:29:07","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":536936,"visible":true,"origin":"","legend":"Receiver operating characteristic curve.\na: ASIS-thickness with a radiographic inclination difference ≥5°, b: PS-thickness with a radiographic anteversion difference ≥5°, c: PS-thickness with both radiographic inclination and anteversion differences ≥5°. \nASIS, anterior-superior iliac spine; PS, pelvic symphysis","description":"","filename":"Fig5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/Fig5.jpg"},{"id":13501265,"identity":"1de6e41b-19ef-4e00-b2fa-51926f9bef8b","added_by":"auto","created_at":"2021-09-16 23:09:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":748470,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-24771/v1/f23f2427-ec7f-47df-800f-557e3434a62f.pdf"}],"financialInterests":"","formattedTitle":"Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study","fulltext":[{"header":"Background","content":" \u003cp\u003eIn total hip arthroplasty (THA), malalignment of implants reportedly leads to increased dislocation rates and polyethylene wear associated with impingement [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Therefore, accurate implantation is very important. In recent years, mechanical intraoperative support devices or navigation systems have been used to place implants accurately [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrevious studies have reported that dislocation after THA occurs more often in patients with obesity because accurate implantation of the acetabular component is difficult in these patients [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Barrack et al. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] conducted a multivariate regression analysis of 1549 THA cases and found that a body mass index (BMI)\u0026thinsp;\u0026ge;\u0026thinsp;30\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e increased the risk of malpositioning of the acetabular cup. They also found that the odds of malpositioning of the acetabular cup increased by \u0026ge;\u0026thinsp;0.2 for each 5\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e increase in BMI.\u003c/p\u003e \u003cp\u003eTo increase the accuracy of cup alignment, especially to reduce a cup-alignment error of \u0026lt;\u0026thinsp;5\u0026deg;, a mechanical intraoperative support device, HipCOMPASS [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], was developed in 2012. This is placed on the skin with the anterior-superior iliac spine (ASIS) and pubic symphysis (PS) as reference points. A previous study reported that the accuracy of cup radiographic inclination and radiographic anteversion, according to Murray\u0026rsquo;s definition [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], was more improved in the HipCOMPASS group compared to that in the group without HipCOMPASS, which used conventional non-navigation techniques [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, another study encountered a high-extremity BMI case in which accurate cup implantation was difficult even when using HipCOMPASS at the developmental stage. Because this device is placed on the skin, there is a possibility that implantation may be impaired in patients with high soft-tissue thickness [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, cup-alignment errors caused by BMI and soft-tissue thickness have not been examined.\u003c/p\u003e \u003cp\u003eThe purpose of this study was to clarify the errors of acetabular-cup positioning caused by BMI and soft-tissue thickness in THA using a mechanical intraoperative support device, HipCOMPASS. Moreover, we also aimed to calculate the cutoff for the error values of \u0026ge;\u0026thinsp;5\u0026deg; for anteversion and inclination, because a previous study stated that the implantation error in radiographic anteversion and radiographic inclination were 2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u0026deg; and 2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u0026deg;, respectively, using HipCOMPASS [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], and the total value of the average and standard deviation was almost 5\u0026deg; for BMI and soft-tissue thickness on the ASIS and/or PS.\u003c/p\u003e "},{"header":"Methods","content":" \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eFrom April 1, 2012 to March 31, 2017, HipCOMPASS (LEXI, Tokyo, Japan) was used in the supine position in 462 patients who underwent primary THA and had not undergone other hip surgeries before the THA. These participants were completely different from those of a previous report [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. We excluded 14 cases; six that required an additional bulky bone graft for severe dysplasia and eight simultaneous bilateral procedures. Therefore, we included only cases where the ipsilateral side was prioritized because the setting of HipCOMPASS had a bilateral effect. Consequently, 448 consecutive cases were included in this study, and we evaluated them retrospectively. They underwent THAs with a purely cementless acetabular component, while the femoral component was cemented or cementless. All THAs were performed using the anterolateral supine approach. Seven senior orthopedic surgeons performed the procedure in these participants. We inserted the acetabular cup according to HipCOMPASS. After press-fit fixation of the acetabular cup, we routinely inserted 1\u0026ndash;3 cancellous screws (AESCLUP, Tuttlingen, Germany) as an additional fixation. Plasmacup MSC or Plasmafit (AESCLUP, Tuttlingen, Germany), a hemispherical titanium plasma-sprayed cup, was used as the acetabular component.\u003c/p\u003e \u003cp\u003eWe conducted this study with approval from the ethics committee of the Niigata University Medical and Dental Hospital (No. 2019\u0026thinsp;\u0026minus;\u0026thinsp;0177), and it was performed in accordance with the Declaration of Helsinki. Since this was a retrospective study, informed consent was waived as the patient data were kept confidential.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMechanical intraoperative support device: HipCOMPASS\u003c/h2\u003e \u003cp\u003eHipCOMPASS consists of a T-plate with three legs of the same length and an angle indicator that can be installed on the plate (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The three legs can be slid over the plate, and the T-plate can be made parallel to the anterior pelvic plane (APP) by pressing each leg on both the ASIS and PS. However, this method causes error in the inclination of the T-plate and APP due to the difference in soft-tissue thickness between the ASIS and PS (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). After anesthesia, both the ASIS and PS were punctured, and a special depth gauge (LEXI, Tokyo, Japan) was pressed into the tissue to measure the thickness of the soft tissue on both the ASIS and PS. The difference in soft-tissue thickness between average values of both the ASIS and PS was calculated. The error between the inclination of the APP and the T-plate were corrected by shortening the leg on the PS by the amount of difference. An angle indicator was adjusted to point to the angle that converted radiographic inclination and radiographic anteversion, planned relative to the functional pelvic plane, to the APP and was placed on the T-plate that was made parallel to the APP to indicate the planned cup-implantation angle. During the operation, the cup was placed at the planned angle by placing the cup holder and the indicator parallel to each other [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003ePreoperative planning\u003c/h2\u003e \u003cp\u003ePreoperative planning was performed using preoperative computed tomography (CT) data installed using ZedHip\u0026reg; three-dimensional (3D) THA planning software (Lexi, Tokyo, Japan). We set the cup radiographic inclination at 40\u0026deg; relative to the functional pelvic plane in all patients. The cup radiographic anteversion was adjusted in the range of 10\u0026ndash;20\u0026deg;, mainly 15\u0026deg;, relative to the functional pelvic plane [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] considering the stem anteversion, according to the \u0026ldquo;combined anteversion theory\u0026rdquo; [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eMeasurements of the soft-tissue thickness\u003c/h2\u003e \u003cp\u003eIf the cup-placement error increased, even with the use of HipCOMPASS, we had to prepare other methods for accurate cup implantation before the operation. In the above-mentioned method of measuring the soft-tissue thickness after anesthesia just before the surgery, other methods were not prepared. Therefore, we measured the soft-tissue thickness on both the ASIS and PS using preoperative CT images. We adjusted the 3D pelvis model according to the functional pelvic plane, the same as the preoperative planning plane stated above, and measured the length from the PS to the skin surface at a right angle to the PS as PS-thickness (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eb). In a similar manner, we also measured the length from bilateral ASISs to the skin surface at a right angle to each ASIS, and the average value of the right and left length was expressed as ASIS-thickness (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003ea). The values of these soft-tissue thickness measurements using CT images were different from the soft-tissue thickness measured when HipCOMPASS was placed on the skin intraoperatively. Therefore, measurements obtained from CT images were not used for intraoperative adjustment of the leg using HipCOMPASS.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eMeasurements of the alignment of the acetabular component\u003c/h2\u003e \u003cp\u003eThe CT scans were examined in patients 1 week after THA for postoperative evaluation of the positioning of both the acetabular and femoral components using ZedHip\u0026reg; software (Lexi, Tokyo, Japan) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The cup-placement angle was evaluated using the ZedHip postoperative evaluation system as described previously [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In this system, the contour of the 3D pelvic model, created from preoperative CT data, was automatically superimposed on a 3D pelvic model created from postoperative CT data, so that the postoperative cup radiographic inclination and anteversion relative to the preoperative functional pelvic plane could be determined. Thus, the errors between the preoperative planning and postoperative cup radiographic inclination and anteversion were calculated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical calculations were performed using SPSS statistical software (SPSS version 24, Inc., Chicago, IL, USA). The correlations between BMI and the differences in radiographic inclination and radiographic anteversion were evaluated using Pearson\u0026rsquo;s correlation coefficients. The unpaired Student\u0026rsquo;s t-test was performed to compare quantitative data, such as age and BMI. Multiple logistic regression analysis was conducted to determine which factor contributed to the presence of an implantation error\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; in radiographic inclination, radiographic anteversion, and both radiographic inclination and radiographic anteversion simultaneously. Moreover, we created receiver operating characteristic (ROC) curves to determine the cutoff values for statistically significant factor(s) of implantation error in radiographic inclination and radiographic anteversion of \u0026ge;\u0026thinsp;5\u0026deg;, determined by multiple logistic regression analysis, for BMI and soft-tissue thickness on the ASIS and/or PS. We also calculated the area under the curve (AUC) from ROC curves, and cutoff values determined the point where the sensitivity\u0026thinsp;+\u0026thinsp;1-specificity was maximum according to the Youden index [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Furthermore, we examined statistical power (type II (β) error) as a post-hoc analysis and a desirable power value of at least 0.8 [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. We defined 0.5 as the effect size (d) and 0.05 as a type Ⅰ (α) error in the t-test and 0.3 as the effect size (d) and 0.05 as a type Ⅰ (α) error in the correlation analysis and multiple logistic regression analysis. We confirmed intraobserver reliability with intraclass correlation coefficients (ICCs), and two-sided 95% confidential intervals (CIs) were calculated to evaluate validations. One observer conducted two measurements with an interval of more than 1 week on 56 randomly selected patients. Furthermore, we compared the measurements to assess the interobserver reliability using a single measurement from two observers, using the same 56 patients as above. Statistical significance of the \u003cem\u003eP\u003c/em\u003e-value was set at .05.\u003c/p\u003e \u003c/div\u003e "},{"header":"Results","content":"\u003cp\u003eIn total, the 448 THAs in this study included 72 males and 376 females, with a mean age of 65.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.6\u0026nbsp;years. Among them, 255 THAs were performed on the right side and 193 on the left side, and the mean BMI was 23.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e. Preoperative diagnoses were osteoarthritis of the hip in 388 cases, osteonecrosis of the femoral head in 42, hip fracture in 6, rapidly destructive arthropathy of the hip in 7, and rheumatoid arthritis in 5 patients. The average cup radiographic inclination was 41.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u0026deg;, and radiographic anteversion was 15.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u0026deg;. Radiographic inclination and radiographic anteversion differences in all participants were 1.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u0026deg; and 0.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u0026deg;, respectively, and the absolute values were 3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u0026deg; and 3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u0026deg;, respectively. Among the THA cases, 71.9% (322/448) were implanted within 5\u0026deg; of both the radiographic inclination and radiographic anteversion, and 4.7% (21/448) were implanted within \u0026ge;\u0026thinsp;5\u0026deg; of both radiographic inclination and radiographic anteversion simultaneously (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). There were significant correlations between absolute values of radiographic anteversion difference and BMI (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.205), ASIS-thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.419), and PS-thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.434). Absolute values of radiographic inclination difference were significantly correlated with ASIS-thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.257) and PS-thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.202) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were statistical differences in BMI, ASIS-thickness, and PS-thickness between patients whose implantation error was \u0026lt;\u0026thinsp;5\u0026deg; and those with a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; error in radiographic inclination and radiographic anteversion (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Multiple logistic regression analysis was conducted with these parameters; ASIS-thickness was considered a significant independent risk factor of a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error in radiographic inclination, and PS-thickness was considered a significant independent risk factor of a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error in radiographic anteversion and in both radiographic anteversion and radiographic inclination simultaneously (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eAccording to the ROC curve, an ASIS-thickness of 16.8 mm was considered the cutoff value for a \u0026ge;5\u0026deg; implantation error in radiographic inclination, while a PS-thickness of 35.0 mm was considered the cutoff value for a \u0026ge;5\u0026deg; implantation error in radiographic anteversion. Furthermore, a PS-thickness of 37.2 mm was considered the cutoff value for a \u0026ge;5\u0026deg; implantation error in both radiographic inclination and radiographic anteversion simultaneously (Fig. 5) (Table 4).\u003c/p\u003e\n\u003cp\u003eRegarding the post-hoc analysis, power values were 0.99 for a \u0026ge;5\u0026deg; implantation error in radiographic inclination, 0.99 for a \u0026ge;5\u0026deg; implantation error in radiographic anteversion, and 0.72 for a \u0026ge;5\u0026deg; implantation error in both radiographic inclination and radiographic anteversion simultaneously according to the unpaired t-test. In terms of the correlation analysis and multiple logistic regression analysis, power values were 0.97 and 0.99, respectively. With regard to intraobserver validity, a high ICC of \u0026gt;0.9 was obtained for both intraobserver and interobserver reliabilities for each parameter (Table 5). No dislocation occurred during the follow-up period of 1 year in these 448 patients.\u003c/p\u003e"},{"header":"Discussion","content":" \u003cp\u003eIn this study, BMI was associated with radiographic anteversion errors, while PS-thickness and ASIS-thickness were associated with both radiographic anteversion errors and radiographic inclination errors (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Furthermore, we found that PS-thickness and ASIS-thickness were independent risk factors for implantation error of the acetabular component in THA using HipCOMPASS. PS-thickness and ASIS-thickness were considered to be more precise influencing factors because they were more related owing to the installation error of HipCOMPASS. Tsukada et al. reported that errors of cup anteversion were larger in patients with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;25\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e than in others [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Similarly, Parratte et al. reported that cup anteversion, measured by postoperative CT, was significantly different from cup anteversion displayed intraoperatively on the navigation screen in patients with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;27\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. However, BMI alone did not give a cutoff value. It is thought that this is because body composition, such as muscle mass and fat mass, differs depending on the person, and the decrease in height due to poor posture affects the BMI. The decrease in height owing to poor posture may affect the progression of hip disease; it can significantly affect BMI, especially in patients undergoing THA. Malpositioning of the acetabular cup increases the risk of dislocation, wear of the bearing surface, and instability of components [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. If the surgeons are able to identify patients whose acetabular components are likely to be malpositioned, they should pay special attention to the implantation. It is well-known that obesity is one of the risk factors of dislocation due to the malpositioning of the acetabular component [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It was previously reported that THA with a CT-based navigation system was not affected by obesity, even though patients\u0026rsquo; BMIs were \u0026ge;\u0026thinsp;30\u0026nbsp;kg/m\u003csup\u003e2\u003c/sup\u003e [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the 448 consecutive cases in this study, no dislocation was observed during the 1-year follow-up period. However, Widmer et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] confirmed that the optimal cup-positioning angle to reduce the risk of dislocation was 40\u0026ndash;42\u0026deg; of radiographic inclination and 20\u0026ndash;28\u0026deg; of radiographic anteversion relative to the APP for considering maximum range of motion (ROM) by using 3D computer simulation. Further age-related changes in the spinal-pelvis alignment over time [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] may lead to later instances of dislocation.\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, this was a retrospective study with a small sample size. Second, the power value of a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error in both radiographic inclination and radiographic anteversion simultaneously was 0.72 according to the unpaired t-test while a desirable power value was at least 0.8. However, we could evaluate the soft-tissue thickness with high reliability with a high ICC value of \u0026gt;\u0026thinsp;0.9, similar to previous studies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Moreover, according to our findings, the surgeons could predict the risk of a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error by the CT images taken before surgery. We are convinced that this is a strong point of the current study. Third, HipCOMPASS itself has several limitations. HipCOMPASS is an alignment guide and has the disadvantage of not being able to guide the location of implantation, which can be performed using CT-based navigation systems. Additionally, HipCOMPASS can be used only for THA in the supine position and cannot be used in the lateral decubitus position. However, HipCOMPASS has the advantage of being inexpensive compared to CT-based navigation systems. The accuracy of cup alignment placed using HipCOMPASS was approximately 3\u0026deg; (Suda et al., 2016); it is slightly inferior to the accuracy of 2\u0026deg; obtained by CT-based navigation systems (Imai et al., 2019); although, it is sufficiently acceptable.\u003c/p\u003e \u003cp\u003eIn this study, we showed that the cup-alignment error tends to be large, especially in patients with a large PS-thickness, when HipCOMPASS is used in THA. Therefore, we recommend the use of other methods, such as CT-based navigation systems, in cases of a PS-thickness\u0026thinsp;\u0026ge;\u0026thinsp;37.2\u0026nbsp;mm on preoperative CT images, because a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error is likely to occur in both radiographic inclination and radiographic anteversion simultaneously.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eAPP: anterior pelvic plane\u003c/p\u003e\n\u003cp\u003eASIS: anterior-superior iliac spine\u003c/p\u003e\n\u003cp\u003eAUC: area under the curve\u003c/p\u003e\n\u003cp\u003eBMI: body mass index\u003c/p\u003e\n\u003cp\u003eCI: confidence interval\u003c/p\u003e\n\u003cp\u003eCT: computed tomography\u003c/p\u003e\n\u003cp\u003eICC: intraclass correlation coefficient\u003c/p\u003e\n\u003cp\u003ePS; pubic symphysis\u003c/p\u003e\n\u003cp\u003eROC: receiver operating characteristic\u003c/p\u003e\n\u003cp\u003eTHA; total hip arthroplasty\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the ethics committee of the Niigata University Medical and Dental Hospital (No. 2019-0177). Since this was a retrospective study, informed consent was waived as the patient data were kept confidential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHS and NI contributed to study conception, design and drafting of manuscript. YH and HS were involved in acquisition, analysis and interpretation of data. NE critically revised the data. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Editage (www.editage.com) for English language editing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e \u003cspan\u003eKennedy JG, Rogers WB, Soffe KE, Sullivan RJ, Griffen DG, Sheehan LJ. Effect of acetabular component orientation on recurrent dislocation, pelvic osteolysis, polyethylene wear, and component migration. J Arthroplasty. 1998;13:530\u0026ndash;4.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTian JL, Sun L, Hu RY, Han W, Tian XB. Correlation of cup inclination angle with liner wear for metal-on-polyethylene in hip primary arthroplasty. Orthop Surg. 2017;9:186\u0026ndash;90.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eIwana D, Nakamura N, Miki H, Kitada M, Hananouchi T, Sugano N. Accuracy of angle and position of the cup using computed tomography-based navigation system in total hip arthroplasty. Comput Aided Surg. 2013;18:187\u0026ndash;94.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFujihara Y, Fukunishi S, Fukui T, Nishio S, Okahisa S, Takeda Y, et al. Use of the G-guide for measuring stem antetorsion during total hip arthroplasty. Orthopedics. 2016;39:e271\u0026ndash;5.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eHaverkamp D, Klinkenbijl MN, Somford MP, Albers GH, van der Vis HM. Obesity in total hip arthroplasty\u0026mdash;does it really matter? A meta-analysis. Acta Orthop. 2011;82:417\u0026ndash;22.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eChee YH, Teoh KH, Sabnis BM, Ballantyne JA, Brenkel IJ. Total hip replacement in morbidly obese patients with osteoarthritis: results of a prospectively matched study. J Bone Joint Surg Br. 2010;92:1066\u0026ndash;71.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eBarrack RL, Krempec JA, Clohisy JC, McDonald DJ, Ricci WM, Ruh EL, et al. Accuracy of acetabular component position in hip arthroplasty. J Bone Joint Surg Am. 2013;95:1760\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSuda K, Ito T, Miyasaka D, Imai N, Minato I, Endo N. Cup implantation accuracy using the HipCOMPASS mechanical intraoperative support device. Springerplus. 2016;5:784.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eMurray DW. The definition and measurement of acetabular orientation. J Bone Joint Surg Br. 1993;75:228\u0026ndash;32.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSugano N, Nishii T, Miki H, Yoshikawa H, Sato Y, Tamura S. Mid-term results of cementless total hip replacement using a ceramic-on-ceramic bearing with and without computer navigation. J Bone Joint Surg Br. 2007;89:455\u0026ndash;60.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eWidmer KH, Zurfluh B. Compliant positioning of total hip components for optimal range of motion. J Orthop Res. 2004;22:815\u0026ndash;21.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eDorr LD, Malik A, Dastane M, Wan Z. Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res. 2009;467:119\u0026ndash;27.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSato T, Koga Y, Omori G. Three-dimensional lower extremity alignment assessment system: Application to evaluation of component position after total knee arthroplasty. J Arthroplasty. 2004;19:620\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eKobayashi K, Sakamoto M, Tanabe Y, Ariumi A, Sato T, Omori G, et al. Automated image registration for assessing three-dimensional alignment of entire lower extremity and implant position using bi-plane radiography. J Biomech. 2009;42:2818\u0026ndash;22.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eAriumi A, Sato T, Kobayashi K, Koga Y, Omori G, Minato I, et al. Three-dimensional lower extremity alignment in the weight-bearing standing position in healthy elderly subjects. J Orthop Sci. 2010;15:64\u0026ndash;70.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eImai N, Takubo R, Suzuki H, Shimada H, Miyasaka D, Tsuchiya K, et al. Accuracy of acetabular cup placement using CT-based navigation in total hip arthroplasty: Comparison between obese and non-obese patients. J Orthop Sci. 2019;24:482\u0026ndash;7.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eFluss R, Faraggi D, Reiser B. Estimation of the Youden index and its associated cutoff point. Biom J. 2005;47:458\u0026ndash;72.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003ePerkins NJ, Schisterman EF. The inconsistency of \u0026lsquo;optimal\u0026rsquo; cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670\u0026ndash;5.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eLenth RV. Some practical guidelines for effective sample size determination. Am Stat. 2001;55:187\u0026ndash;93.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTsukada S, Wakui M. Decreased accuracy of acetabular cup placement for imageless navigation in obese patients. J Orthop Sci. 2010;15:758\u0026ndash;63.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eParratte S, Argenson JNA. Validation and usefulness of a computer-assisted cup-positioning system in total hip arthroplasty. J Bone Joint Surg Am. 2009;89:494\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eSutherland CJ, Wilde AH, Borden LS, Marks KE. A ten-year follow-up of one hundred consecutive Muller curved-stem total hip-replacement arthroplasties. J Bone Joint Surg Am. 1982;64:970\u0026ndash;82.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eDickob M, Martini T. The cementless PM hip arthroplasty. J Bone Joint Surg Br. 1996;78:195\u0026ndash;9.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eKelley SS, Lachiewicz PF, Hickman JM, Paterno SM. Relationship of femoral head and acetabular size to the prevalence of dislocation. Clin Orthop Relat Res. 1998;355:163\u0026ndash;70.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eConroy JL, Whitehouse SL, Graves SE, Pratt NL, Ryan P, Crawford RW. Risk factors for revision for early dislocation in total hip arthroplasty. J Arthroplasty. 2008;23:867\u0026ndash;72.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eIshida T, Inaba Y, Kobayashi N, Iwamoto N, Yukizawa Y, Choe H, et al. Changes in pelvic tilt following total hip arthroplasty. J Orthop Sci. 2011;16:682\u0026ndash;8.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eTamura S, Nishihara S, Takao M, Sakai T, Miki H, Sugano N. Does pelvic sagittal inclination in the supine and standing positions change over 10 years of follow-up after total hip arthroplasty? J Arthroplasty. 2017;32:877\u0026ndash;82.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eImai N, Miyasaka D, Suzuki H, Tsuchiya K, Ito T, Minato I, et al. The anteroposterior axis of the tibia is adjusted to approximately a right angle to the anterior pelvic plane in the standing position in patients with hip dysplasia similar to normal subjects: a cross-sectional study. J Orthop Surg Res. 2018;13:105.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eImai N, Miyasaka D, Tsuchiya K, Suzuki H, Ito T, Minato I, et al. Evaluation of pelvic morphology in female patients with developmental dysplasia of the hip using three-dimensional computed tomography: A cross-sectional study. J Orthop Sci. 2018;23:788\u0026ndash;92.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e \u003cspan\u003eImai N, Suzuki H, Nozaki A, Miyasaka D, Tsuchiya K, Ito T, et al. Evaluation of anatomical pelvic parameters between normal, healthy men and women using three-dimensional computed tomography: a cross-sectional study of sex-specific and age-specific differences. J Orthop Surg Res. 2019;14:126.\u003c/span\u003e \u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10px; line-height: 32px; font-family: Verdana, Geneva, sans-serif; color: rgb(0, 0, 0);\"\u003eTable 1.\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eCorrelation between BMI, ASIS-thickness, PS-thickness, and THA acetabular cup radiographic inclination difference and radiographic anteversion difference with the HipCOMPASS system\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width: 784px;border-collapse: collapse;border: none;\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 181.625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 26.1pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 26.1pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 26.1pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 26.1pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 181.625px;border: none;padding: 0in 5.4pt;height: 30.7pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic inclination difference (\u0026deg;)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border: none;padding: 0in 5.4pt;height: 30.7pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.110 (.240)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border: none;padding: 0in 5.4pt;height: 30.7pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.257 (\u0026lt;.001)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border: none;padding: 0in 5.4pt;height: 30.7pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.202 (\u0026lt;.001)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 181.625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic anteversion difference (\u0026deg;)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.205 (\u0026lt;.001)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.419 (\u0026lt;.001)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 181.625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.434 (\u0026lt;.001)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eData are expressed as correlation coefficient (\u003cem\u003eP\u003c/em\u003e-value)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cstrong\u003e\u003cspan style=\"line-height: 32px;\"\u003eTable 2.\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"line-height: 32px;\"\u003eUnivariate analysis of BMI, ASIS-thickness, and PS-thickness between the patients whose THA acetabular cup-implantation errors with the HipCOMPASS system were \u0026lt;5\u0026deg; and those that were \u0026ge;5\u0026deg; in acetabular cup radiographic inclination and radiographic anteversion\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width: 784px;border-collapse: collapse;border: none;\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic inclination difference \u0026lt;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic inclination difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cem\u003e\u003cspan style=\"line-height: 32px;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 32px;\"\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eNumber\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e322\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e116\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e23.5\u0026nbsp;\u0026plusmn;\u0026nbsp;3.7\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e24.7\u0026nbsp;\u0026plusmn;\u0026nbsp;4.3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.017\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e17.4\u0026nbsp;\u0026plusmn;\u0026nbsp;11.8\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e24.2\u0026nbsp;\u0026plusmn;\u0026nbsp;15.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e30.0\u0026nbsp;\u0026plusmn;\u0026nbsp;11.0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e35.0\u0026nbsp;\u0026plusmn;\u0026nbsp;13.2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 22.75pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 22.75pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic anteversion difference \u0026lt;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 22.75pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic anteversion difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 22.75pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cem\u003e\u003cspan style=\"line-height: 32px;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 32px;\"\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eNumber\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e347\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e101\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e23.4\u0026nbsp;\u0026plusmn;\u0026nbsp;3.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e25.0\u0026nbsp;\u0026plusmn;\u0026nbsp;4.3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e15.9\u0026nbsp;\u0026plusmn;\u0026nbsp;10.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e28.3\u0026nbsp;\u0026plusmn;\u0026nbsp;16.3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e28.4\u0026nbsp;\u0026plusmn;\u0026nbsp;9.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e39.6\u0026nbsp;\u0026plusmn;\u0026nbsp;13.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 18.65pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 18.65pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eAt least radiographic inclination or radiographic anteversion difference \u0026lt;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 18.65pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBoth radiographic inclination and radiographic anteversion difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 18.65pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cem\u003e\u003cspan style=\"line-height: 32px;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 32px;\"\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eNumber\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e427\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e21\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e23.6\u0026nbsp;\u0026plusmn;\u0026nbsp;3.8\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e24.9\u0026nbsp;\u0026plusmn;\u0026nbsp;4.9\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.045\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e17.9\u0026nbsp;\u0026plusmn;\u0026nbsp;12.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e34.6\u0026nbsp;\u0026plusmn;\u0026nbsp;17.2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border: none;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156.890625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"21.428571428571427%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e30.2\u0026nbsp;\u0026plusmn;\u0026nbsp;11.0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 230.765625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"31.632653061224488%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e44.9\u0026nbsp;\u0026plusmn;\u0026nbsp;14.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108.109375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 31.55pt;\" width=\"15.306122448979592%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eContinuous values are expressed as average \u0026plusmn; standard deviation\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cstrong\u003e\u003cspan style=\"line-height: 32px;\"\u003eTable 3.\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"line-height: 32px;\"\u003eMultiple logistic regression analysis of BMI, ASIS-thickness, and PS-thickness between the patients whose THA acetabular cup-implantation errors with the HipCOMPASS system were \u0026lt;5\u0026deg; and those that were \u0026ge;5\u0026deg; in radiographic inclination and radiographic anteversion\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width: 784px;border-collapse: collapse;border: none;\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 132.265625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;vertical-align: top;\" valign=\"top\" width=\"18.367346938775512%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 144.96875px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;vertical-align: top;\" valign=\"top\" width=\"20.408163265306122%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eOdds ratio\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cem\u003e\u003cspan style=\"line-height: 32px;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 32px;\"\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 20.8pt;vertical-align: top;\" valign=\"top\" width=\"26.53061224489796%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e95% CI\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 132.265625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"18.367346938775512%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eradiographic inclination difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"20.408163265306122%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.985\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.439\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"26.53061224489796%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.899-1.080\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.045\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.002\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.002-1.090\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.992\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.077\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.944-1.039\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 132.265625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"18.367346938775512%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eradiographic anteversion difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"20.408163265306122%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.847\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.754\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"26.53061224489796%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.762-1.043\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.039\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.076\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.996-1.084\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.085\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.039\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.030-1.143\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 132.265625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"18.367346938775512%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBoth radiographic inclination and radiographic anteversion difference \u0026ge;5\u0026deg;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"20.408163265306122%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.913\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"17.346938775510203%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.300\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"26.53061224489796%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.768-1.085\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.024\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e.146\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border: none;padding: 0in 5.4pt;height: 33.45pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.962-1.091\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 144.96875px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 33.5pt;vertical-align: top;\" valign=\"top\" width=\"25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 33.5pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.067\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120.515625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 33.5pt;vertical-align: top;\" valign=\"top\" width=\"21.25%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193.90625px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;height: 33.5pt;vertical-align: top;\" valign=\"top\" width=\"32.5%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.038-1.097\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eBMI, body mass index; ASIS-thickness, anterior-superior iliac spine thickness; PS-thickness, pubic symphysis; THA, total hip arthroplasty; CI, confidence interval.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cstrong\u003e\u003cspan style=\"line-height: 32px;\"\u003eTable 4.\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"line-height: 32px;\"\u003eArea under curve and cutoff values by receiver operating characteristic curves\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width: 784px;border-collapse: collapse;border: none;\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149.484375px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"21.27659574468085%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eImplantation error\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.484375px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"10.638297872340425%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eFactor\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eAUC\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eCutoff value (mm)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eSensitivity\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.84375px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1-Specificity\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e95% CI\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border-top-width: 1pt;border-style: solid none;border-top-color: windowtext;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cem\u003e\u003cspan style=\"line-height: 32px;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"line-height: 32px;\"\u003e-value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149.484375px;border: none;padding: 0in 5.4pt;\" width=\"21.27659574468085%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026ge;5\u0026deg; in radiographic inclination\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.484375px;border: none;padding: 0in 5.4pt;\" width=\"10.638297872340425%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border: none;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.645\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border: none;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e16.8\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border: none;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.643\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.84375px;border: none;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.390\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;border: none;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.573-0.718\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border: none;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149.484375px;border: none;padding: 0in 5.4pt;\" width=\"21.27659574468085%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026ge;5\u0026deg; in radiographic anteversion\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.484375px;border: none;padding: 0in 5.4pt;\" width=\"10.638297872340425%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border: none;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.756\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border: none;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e35.0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border: none;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.693\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.84375px;border: none;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.186\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;border: none;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.684-0.818\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border: none;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149.484375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"21.27659574468085%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026ge;5\u0026deg; in both radiographic inclination and radiographic anteversion simultaneously\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67.484375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"10.638297872340425%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.808\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e37.2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.25px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"11.702127659574469%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.833\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90.84375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.248\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 91px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"13.829787234042554%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.703-0.913\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.875px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: windowtext;padding: 0in 5.4pt;\" width=\"8.51063829787234%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;text-align: center;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026lt;.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness, anterior-superior iliac spine thickness; AUC, area under the cureve; PS-thickness, pubic symphysis; CI, confidence interval.\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cstrong\u003e\u003cspan style=\"line-height: 32px;\"\u003eTable 5.\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"line-height: 32px;\"\u003eIntra- and interobserver reliabilities\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width: 784px;border-collapse: collapse;border: none;\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"35.35353535353536%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 240.328125px;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"32.323232323232325%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eIntraobserver reliability\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 240.328125px;border-top-width: 1pt;border-style: solid none;border-top-color: rgb(127, 127, 127);border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"32.323232323232325%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eInterobserver reliability\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"36.08247422680412%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eMAD\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eICC\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eMAD\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eICC\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"36.08247422680412%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic inclination\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.59\u0026nbsp;\u0026plusmn;\u0026nbsp;0.71\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.972\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.66\u0026nbsp;\u0026plusmn;\u0026nbsp;0.73\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.952\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"36.08247422680412%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eRadiographic anteversion\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.68\u0026nbsp;\u0026plusmn;\u0026nbsp;0.72\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.962\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e1.07\u0026nbsp;\u0026plusmn;\u0026nbsp;1.11\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.932\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"36.08247422680412%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003eASIS-thickness\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.50\u0026nbsp;\u0026plusmn;\u0026nbsp;0.43\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.999\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.88\u0026nbsp;\u0026plusmn;\u0026nbsp;0.78\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.999\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 260.25px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"36.08247422680412%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003ePS-thickness\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.53\u0026nbsp;\u0026plusmn;\u0026nbsp;0.45\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.999\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 146.859375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.61855670103093%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.73\u0026nbsp;\u0026plusmn;\u0026nbsp;0.52\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79.09375px;border-style: none none solid;border-bottom-width: 1pt;border-bottom-color: rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"11.34020618556701%\"\u003e\n \u003cp style='margin: 0in 0in 0.0001pt;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"line-height: 32px;\"\u003e0.999\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin: 0in 0in 0.0001pt 0.5in;font-size:14px;font-family: \"Times New Roman\", serif;line-height: 28px;text-align: left;'\u003e\u003cspan style=\"font-size: 10px; line-height: 32px; font-family: Verdana, Geneva, sans-serif; color: rgb(0, 0, 0);\"\u003eMAD, mean absolute difference; SD, standard deviation; ASIS-thickness: soft-tissue thickness of anterior superior iliac spine, PS-thickness: soft-tissue thickness of pubic symphysis. \u0026nbsp;All ICCs had a P-value \u0026lt; 0.05.\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"HipCOMPASS, total hip arthroplasty, cup-alignment accuracy, body mass index, soft-tissue thickness","lastPublishedDoi":"10.21203/rs.3.rs-24771/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-24771/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eHipCOMPASS, a mechanical intraoperative support device used in total hip arthroplasty (THA), improves the cup-alignment accuracy. However, alignment accuracy in obese patients has not been examined. We aimed to compare the cup-alignment accuracy, using HipCOMPASS, between patients with and without obesity.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe retrospectively evaluated 448 consecutive patients who underwent primary THA using HipCOMPASS. We measured the soft-tissue thickness of the anterior-superior iliac spine (ASIS) and pubic symphysis using preoperative computed tomography (CT) images and the difference in cup angle pre- and postoperatively based on the cup-alignment error on CT. We used Pearson coefficients to determine the correlation of body mass index (BMI) and soft-tissue thickness with cup-alignment error. We created receiver operating characteristic (ROC) curves to determine the cutoff value for statistically significant cup-alignment error factors in radiographic inclination and anteversion of \u0026ge;\u0026thinsp;5\u0026deg;.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere were significant correlations between the absolute value of radiographic anteversion difference and BMI (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.205), ASIS thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.419), and pubic symphysis thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.434). The absolute value of radiographic inclination difference was significantly correlated with ASIS (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.257) and pubic symphysis thickness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.202). The ROC curve showed a pubic symphysis thickness of 37.2\u0026nbsp;mm for a\u0026thinsp;\u0026ge;\u0026thinsp;5\u0026deg; implantation error in both radiographic inclination and anteversion simultaneously. The cup-alignment error for HipCOMPASS was large in patients whose pubic symphysis thickness was \u0026ge;\u0026thinsp;37.2\u0026nbsp;mm on preoperative CT.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWe recommend using methods other than HipCOMPASS, including computed tomography-based navigation systems, in obese patients.\u003c/p\u003e","manuscriptTitle":"Accuracy of acetabular cup implantation, as a function of body mass index and soft-tissue thickness, with a mechanical intraoperative support device: A retrospective observational study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-05-04 20:29:05","doi":"10.21203/rs.3.rs-24771/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"084fe862-641f-42ac-9359-56fb49d91789","owner":[],"postedDate":"May 4th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":93393,"name":"Orthopedic Surgery"}],"tags":[],"updatedAt":"2020-08-07T14:10:37+00:00","versionOfRecord":[],"versionCreatedAt":"2020-05-04 20:29:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-24771","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-24771","identity":"rs-24771","version":["v1"]},"buildId":"oE6Zbj460LM0Up2FdVbMZ","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}