Marker-based versus model-based radiostereometric analysis of total knee arthroplasty migration: a reanalysis with comparable mean outcomes despite distinct types of measurement error

Hamersveld, Koen T. van; Mheen, P.J. Marang-van de; Koster, Lennard A; Nelissen, Rob G H H; Kaptein, Bart L

doi:10.1080/17453674.2019.1605692

Cited by 17 publications

(6 citation statements)

References 14 publications

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“…An incorrect rotational alignment of the reference model can lead to incorrect rotations and hence inaccurate translation measurement. This effect of rotation on translation is explained by Beardsley et al and Van Hamersveld et al [ 21 , 22 ] Therefore, striving for a well three-dimensional spread and stable rigid body as a reference for migration calculation is still important, even if rotations are left out of consideration. However, the small size of the surrounding bone makes it difficult to ensure this in the TMC joint.…”

Section: Discussionmentioning

confidence: 99%

A radiostereometric and clinical long-term follow-up study of the surface replacement trapeziometacarpal joint prosthesis

Brinke

Mathijssen

Blom

et al. 2021

BMC Musculoskelet Disord

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Background The aim of this study was to determine long-term survival and clinical outcomes of the surface replacement trapeziometacarpal joint prosthesis (SR™TMC) and to evaluate implant migration using radiostereometric analysis (RSA). Methods In this clinical long-term follow-up study outcomes of ten patients who received the SR™TMC joint prosthesis were evaluated using DASH and Nelson scores, Visual Analogue Scale (VAS) of pain, and key pinch strength. RSA-radiographs were obtained direct postoperatively and 6 months, 1, 5 and 10 years postoperatively and were analyzed using model-based RSA software. Results During follow-up, two early revisions took place. Mean pre-operative DASH and Nelson scores were 54 (SD 15) and 54 (SD 17), improved significantly after 6 months (DASH 25 (SD 20), Nelson 75 (SD 18)) and remained excellent during long-term follow-up in all patients with a stable implant. At final follow-up, clinical scores deteriorated clearly in two patients with a loose implant in situ. Conclusions Long-term survival of the SR™TMC joint prosthesis is relatively poor. However, clinical outcomes improved significantly in the short-term and remained excellent in the long-term in those patients with a stable implant, but deteriorated clearly in case of loosening. The role of RSA in TMC joint arthroplasty is potentially valuable but needs to be further investigated. Several challenges of RSA in the TMC joint have been addressed by the authors and suggestions to optimize RSA-data are given. Trial registration This study was registered in the Netherlands Trial Register (NL7126).

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Section: Discussionmentioning

confidence: 99%

A radiostereometric and clinical long-term follow-up study of the surface replacement trapeziometacarpal joint prosthesis

Brinke

Mathijssen

Blom

et al. 2021

BMC Musculoskelet Disord

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“…For example, it would be of interest to analyze the effect of certain biomarkers and bone mineral density on migration in such a large group of patients with long-term migration data. Another limitation was that different RSA methods were used across studies, which might result in patients from 1 study being more susceptible to certain types of measurement errors than others 13 . However, we did statistically correct for clustering of patients within each study.…”

Section: Discussionmentioning

confidence: 99%

“…In uncemented components, high initial migration may also be physiological and merely part of a biphasic migration pattern with high initial migration (i.e., a settling phase) before stabilizing 2,6 . Previous long-term follow-up RSA studies have shown that long-lasting biological fixation can be achieved despite high initial migration in both uncemented components with a hydroxyapatite coating and uncemented components made of highly porous metal 12,14,26 . Uncemented components without an osseointegration-promoting surface, however, more often show a prolonged settling phase (possibly >2 years) or may not stabilize at all 14,27 .…”

Section: Discussionmentioning

confidence: 99%

“…All studies were randomized controlled trials (RCTs) that compared implants of the same manufacturer within each study with either different fixation methods, different insert designs, or slight alterations in tibial component design (Table I). One study (by Henricson and Nilsson) was changed in design from an RCT to a comparison of 2 consecutive cohorts for logistical reasons 12 . All primary studies were approved by local ethics committees, and approval for the pooling of data was waived for the present study (entry no.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the RSA methods used were described in each of the individual studies (Table I). It is known that translations are systematically overestimated in marker-based RSA using polyethylene insert markers, as compared with model-based RSA, because of the different reference origin used for migration calculations 13 ; thus, pooling translation data from studies using different RSA methods may not be justifiable. In contrast, maximum total point motion, which is the length of the translation vector of either the point on the tibial component (for model-based RSA) or the marker that moved the most, is not overestimated by 1 method compared with the other.…”

Section: Methodsmentioning

confidence: 99%

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Risk Factors for Tibial Component Loosening

Hamersveld

Mheen

Tsonaka

et al. 2021

Journal of Bone and Joint Surgery

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Background: Radiostereometric analysis (RSA) is a highly accurate tool to detect implant migration and predict loosening following total knee arthroplasty (TKA). However, little is known about the predisposing risk factors for implant migration, nor which migration profile should be considered physiological (i.e., merely part of an implant-settling phase) and which should be considered pathological (i.e., having a high probability for implant loosening). By pooling individual participant data from long-term follow-up RSA studies, we aimed to identify predisposing risk factors for tibial component loosening.Methods: Individual data were collected for 630 patients from 11 RSA studies. The repeated measurements were analyzed with use of a linear mixed-effects model, determining the effect of age, sex, body mass index, diagnosis, preoperative and postoperative limb alignment, and prosthesis characteristics on tibial component migration over time, taking into account the clustering of patients within studies.Results: High initial migration was found to result in early mechanical loosening in 18 cases (2.9%) and septic loosening in 2 cases (0.3%), whereas stabilization of high initial migration occurred in 17 cases (2.7%). Late loosening occurred in 13 cases (2.1%). All other 580 cases (92.1%) showed early stabilization and remained stable over time. Mixed-effects model analyses showed that for cemented prostheses, sex, diagnosis, and posterior cruciate ligament type had an effect on migration, but these differences were nonsignificant when analyzing migration from 3 months onwards. Uncemented prostheses aligned in varus showed more migration than neutrally and valgus-aligned TKAs (p = 0.031), and this difference increased over time (p < 0.001). Significantly higher migration was observed following uncemented TKA without an osseointegration-promoting surface (p < 0.001).Conclusions: For cemented prostheses, increased migration during the first 3 postoperative months was observed for Disclosure: A grant was received from the Dutch Arthritis Foundation (LLP13) and from Stryker. The sponsors did not take any part in the design, conduct, analysis, and interpretations stated in the manuscript. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/G474).

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Accuracy and precision of Volumetric Matching Micromotion Analysis (V3MA) is similar to RSA for tibial component migration in TKA

de Laat,

Koster,

Stoel

et al. 2024

Journal Orthopaedic Research

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Radiostereometric analysis (RSA) is the current gold standard to determine implant migration, but it requires bone markers and special equipment. Therefore, we developed VoluMetric Matching Micromotion Analysis (V3MA), a software program for Computed Tomography‐based radiostereometric analysis (CT‐RSA). This study aimed to determine the accuracy and precision of V3MA in vitro compared to RSA and provide a clinical proof of concept. The accuracy (RMSE (Root Mean Squared Error)) and precision (SD (standard deviation)) of V3MA were compared to RSA. A tibial component was placed in 21 different positions within a cadaveric bone to assess accuracy. For precision, a total of 20 repeated zero‐migration examinations from 4 cadaveric bones with cemented tibial components were performed. In 6 total knee arthroplasty (TKA) patients 1 to 5 year migration was measured with V3MA and RSA. V3MA accuracy ranged between 0.02 and 0.09 mm for translations and was 0.01° for internal–external rotations. For RSA, the accuracy ranged between 0.03 and 0.09 mm for translations and was 0.09° for internal‐external rotations. V3MA precision ranged between 0.01 and 0.06 mm for translations and 0.02 to 0.07° for rotations. RSA precision ranged between 0.00 and 0.06 mm for translations and 0.04 to 0.25° for rotations. V3MA was successful in 6 clinical cases and no systematic bias was present. In conclusion, the accuracy and precision of V3MA were similar to RSA. Therefore, V3MA is a promising alternative to RSA in migration measurements of tibial components in TKA.

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Marker-based versus model-based radiostereometric analysis of total knee arthroplasty migration: a reanalysis with comparable mean outcomes despite distinct types of measurement error

Abstract: (2019) Marker-based versus modelbased radiostereometric analysis of total knee arthroplasty migration: a reanalysis with comparable mean outcomes despite distinct types of measurement error,

Cited by 17 publications

References 14 publications

A radiostereometric and clinical long-term follow-up study of the surface replacement trapeziometacarpal joint prosthesis

A radiostereometric and clinical long-term follow-up study of the surface replacement trapeziometacarpal joint prosthesis

Risk Factors for Tibial Component Loosening

Accuracy and precision of Volumetric Matching Micromotion Analysis (V3MA) is similar to RSA for tibial component migration in TKA

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