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An Intraoperative Method for Measuring Acetabular Cup Inclination and Anteversion in Total Hip Arthroplasty Using an Inertial Measurement Unit Cover

An Intraoperative Method for Measuring Acetabular Cup Inclination and Anteversion in Total Hip Arthroplasty Using an Inertial Measurement Unit

Open Access
|Apr 2026

Figures & Tables

Fig. 1.

Overview of the three steps in the THA procedure.

Fig. 2.

Definitions of operative inclination θi, anteversion θa, and human body coordinate system {B}, and the illustration of cup axis and equivalent angles for θi and θa in system {B}.

Fig. 3.

Definitions of the IMU coordinate system {I} and the world coordinate system {W}.

Fig. 4.

The full view image of the 3-axis tilt table used in experiments (left) and the close-up image of the single-axis tilt table (right), which is the constituent unit of the bottom two layers. The threaded rod simulates the axis of the acetabular cup.

Fig. 5.

Angle estimation accuracy of the IMU for single-axis rotation. The true values (blue line) and estimated values (orange line) are referenced to the left vertical axis, while their absolute errors (green line) are referenced to the right vertical axis.

Fig. 6.

Coordinates of rotation axis unit vector uW in {W} acquired during the registration phase using (17), recorded at four positions.

Fig. 7.

Comparison of estimated (θi,θa) values vs. true values. A larger magnitude of the error vector indicates greater error.

Fig. 8.

Comparison of error vectors in different IMU poses.

Fig. 9.

Comparison of error vectors at different times.

Performance comparison among different prosthesis pose estimation technologies for THA_

This workChen et al. (2021) [16]Tang et al. (2025) [17]Computer-assisted system [11]
Sensor typeIMUIMUIMUcamera
Angular errorRMSE: θi = 0.28° θa = 0.30°RMSE: θi = 3.26° θa = 3.05°MAE: θi = 2.3° θa = 2.2°MAE: θi = 1.8° θa = 2.0°
Prosthesis adaptabilityhighlowlowhigh
Invasivenessnon-invasivenon-invasivenon-invasiveinvasive
Radiation exposurenononoyes
Experimental environment3-axis tilt tablecustomized measuring devicein vitro tests on sawbonesreal cases (25 patients)

Definitions of the three coordinate systems: world system{W}, IMU system {I}, and body system {B}_

Name & notationDefinition
WorldxW: pointing east
systemyW: pointing north
{W}zW: pointing up, orthogonal to the local Earth surface
IMUxI: pointing right (viewing from front-facing direction)
systemyI: pointing up (viewing from front-facing direction)
{I}zI: pointing forward (front-facing direction)
BodyxB: pointing to the body’s right
systemyB: pointing forward
{B}zB: pointing up along the spinal axis

Angle estimation accuracy (using RMSE and MAPE) of rotations in the three axes_

Rotation axisRMSEMAPE
z-axis0.315°2.5 %
y-axis0.409°3.3 %
x-axis0.423°3.6 %

Part of the data (estimated coordinates of rotation axis vector at Position 1 & 2) and the corresponding test conditions (IMU pose & rotation angle)_

Tilt table positionIMU poseRotation angleEstimated axis vector uxW,uyW,uzW \left( {u_x^{\rm{W}},u_y^{\rm{W}},u_z^{\rm{W}}} \right)
Position 1Pose A10°(−0.586, 0.810, −0.024)
Pose B(−0.565, 0.819, 0.103)
Pose C(−0.579, 0.808, −0.111)
Pose D(−0.601, 0.799, −0.022)
Pose E(−0.553, 0.812, −0.186)
Position 2Pose A( 0.993, 0.119, 0.020)
( 0.993, 0.120, 0.006)
( 0.993, 0.119, 0.006)
12°( 0.993, 0.117, −0.004)
15°( 0.994, 0.114, 0.007)

Results of θi and θa measurement accuracy experiment_

Test timeθi RMSEθa RMSEAverage error vector magnitude
0 min0.469°0.234°0.494°
10 min0.618°1.085°1.199°
20 min0.791°1.586°1.704°
Language: English
Page range: 117 - 126
Submitted on: Jun 3, 2025
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Accepted on: Mar 10, 2026
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Published on: Apr 11, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: Volume open

© 2026 Shaojie Su, Zhenwei Wei, Yangsheng Chen, Zhaofeng Lin, published by Slovak Academy of Sciences, Institute of Measurement Science
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.