Precision of CT-based micromotion analysis is comparable to radiostereometry for early migration measurements in cemented acetabular cups

Brodén, Cyrus; Sandberg, Olof; Olivecrona, Henrik; Emery, Roger; Sköldenberg, Olof

doi:10.1080/17453674.2021.1906082

Cited by 18 publications

(34 citation statements)

References 15 publications

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“…Our findings suggest that the precision of CTMA in measuring proximal cup migration postoperatively (double examinations) and up to 1 year is comparable to the standard RSA and can be considered for assessment of early implant migration. This finding is in accordance with previous experimental and clinical studies (6,30).…”

Section: Discussionsupporting

confidence: 94%

“…Experimental studies using phantoms, in vivo studies with pilot patients (5,6,(37)(38)(39)(40) and clinical studies (30,31,40) over the last few years have shown that, with methods using low-dose CT scans, precision can be achieved that is very much comparable to RSA while radiation dosage also stays at low levels (41). In previous studies the mean effective dose for CTMA has been reported at 0.33 mSv for an experimental hip study (6) and 0.2-2.3 mSv for a clinical hip study (31).…”

Section: Discussionmentioning

confidence: 99%

“…A drawback of CTMA is the lack of the condition number and mean error as in RSA (13,14). With CTMA, the correctness of the analysis and measurements is determined by the color-coding system provided by the software (30). In that essence, the assessment is based solely on the analyst's or user's experience.…”

Section: Discussionmentioning

confidence: 99%

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Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year

Angelomenos

Mohaddes

Itayem

et al. 2022

ActaO

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Background and purpose: Computed tomography micromotion analysis (CTMA) can be used to determine implant micro-movements using low-dose CT scans. By using CTMA, a non-invasive measurement of joint implant movement is enabled. We evaluated the precision of CTMA in measuring early cup migration. Standard marker-based radiostereometric analysis (RSA) was used as reference. We hypothesised that CTMA can be used as an alternative to RSA in assessing implant micromotions.Patients and methods: We included 30 patients undergoing total hip arthroplasty (THA). Acetabular cup migration at 1 year was measured with RSA and CTMA. To determine the precision of both methods, 20 double examinations (postoperatively) with repositioning of the patients were performed. The precision was calculated from zero by assuming that there was no motion of the prosthesis between the 2 examinations.Results: The precision of RSA ranged from 0.06 to 0.15 mm for translations and 0.21° to 0.63° for rotations. Corresponding values for CTMA were 0.06 to 0.13 mm and 0.23° to 0.35°. A good level of agreement was found between the methods regarding cup migration and rotation at 1 year.Interpretation: The precision of CTMA in measuring acetabular cup migration and rotation is comparable to marker-based RSA. CTMA could possibly thus be used as an alternative method to detect early implant migration.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year

Angelomenos

Mohaddes

Itayem

et al. 2022

ActaO

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“…We performed the CTMA glenoid component migration analyses relying on the surface anatomy of the scapular bone, which is an advantageous feature of CTMA compared with RSA that makes it possible to analyze data without being dependent on the number of inserted beads and their distribution in the bone during surgery. In RSA, for example, marker occlusion can lead to exclusion of RSA examinations and loss of data ( 21 , 22 ). This CTMA feature therefore makes insertion of beads in the bone redundant.…”

Section: Discussionmentioning

confidence: 99%

CT-based micromotion analysis method can assess early implant migration and development of radiolucent lines in cemented glenoid components: a clinical feasibility study

Brodén

Reilly

Khanna

et al. 2022

ActaO

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Background and purpose: CT micromotion analysis (CTMA) has been considered as an alternative to radiostereometry (RSA) for assessing early implant migration of orthopedic implants. We investigated the feasibility of CTMA to assess early migration and the progression of radiolucent lines in shoulder arthroplasties over 24 months using sequential low-dose CT scans. Patients and methods: 7 patients were included and underwent 9 primary total shoulder arthroplasties. We made CT scans preoperatively, within 1 week postoperatively, and after 3, 6, 12, and 24 months. At each follow-up, postoperative glenoid migration and any development of radiolucent lines were assessed. Clinical outcomes were recorded at all time points except within 1 week postoperatively. Results: For the glenoid component, the median translation and median rotation were 0.00–0.10 mm and –1.53° to 1.05° at 24 months. Radiolucent lines could be observed around all glenoid components. The radiolucent lines developed from the periphery to the center of the implant for 6 glenoid components during follow-up. The Constant Score improved from a mean of 30 (21–51) preoperatively to 69 (41–88) at 24 months. Interpretation: CTMA can be used to identify early migration and the development of radiolucent lines over time in glenoid components. Clinical trials with a larger sample size and longer follow-up are needed to establish the relationship between migration, radiolucent lines, loosening, and clinical outcome.

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“…Computed tomography (CT) is a ubiquitous method to create high-resolution 3D images of voxels of submillimetre size. A commercial solution, computed tomography micromotion analysis (CTMA, Sectra, Linköping, Sweden) is a promising alternative to RSA which uses CT scans to determine movements between implants and bones in a similar fashion to RSA with similar accuracy and precision, 9 – 12 but is not yet available for use with all implants.…”

Section: Introductionmentioning

confidence: 99%

Low dose CT-based spatial analysis (CTSA) to measure implant migration after ceramic hip resurfacing arthroplasty (HRA): A phantom study

Clarke

Logishetty

Cobb

2023

Proc Inst Mech Eng H

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Implant migration is a predictor of arthroplasty survivorship. It is crucial to monitor the migration of novel hip prostheses within premarket clinical investigations. RSA is the gold standard method, but requires calibrated radiographs using specialised equipment. A commercial computed tomography micromotion analysis solution is a promising alternative but is not yet available for use with monobloc ceramic implants. This study aimed to develop and validate a CT-based spatial analysis (CTSA) method for use with ceramic implants. A phantom study was undertaken to assess accuracy and precision. A ceramic hip resurfacing arthroplasty (HRA) and 20 tantalum beads were implanted into a synthetic hip model and mounted onto a 6-degree of freedom motion stage. The hip was repeatedly scanned with a low dose CT protocol, with imposed micromovements. Data were interrogated using a semiautomated technique. The effective radiation dose for each scan was estimated to be 0.25 mSv. For the head implant, precision ranged between 0.11 and 0.28 mm for translations and 0.34°–0.42° for rotations. For the cup implant, precision ranged between 0.08 and 0.11 mm and 0.19° and 0.42°. For the head, accuracy ranged between 0.04 and 0.18 mm for translations and 0.28°–0.46° for rotations. For the cup, accuracy ranged between 0.04 and 0.08 mm and 0.17° and 0.43°. This in vitro study demonstrates that low dose CTSA of a ceramic HRA is similar in accuracy to RSA. CT is ubiquitous, and this method may be an alternative to RSA to measure prosthesis migration.

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Precision of CT-based micromotion analysis is comparable to radiostereometry for early migration measurements in cemented acetabular cups

Abstract: Emery & Olof Sköldenberg (2021): Precision of CT-based micromotion analysis is comparable to radiostereometry for early migration measurements in cemented acetabular cups, Acta Orthopaedica,

Cited by 18 publications

References 15 publications

Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year

Precision of low-dose CT-based micromotion analysis technique for the assessment of early acetabular cup migration compared with gold standard RSA: a prospective study of 30 patients up to 1 year

CT-based micromotion analysis method can assess early implant migration and development of radiolucent lines in cemented glenoid components: a clinical feasibility study

Low dose CT-based spatial analysis (CTSA) to measure implant migration after ceramic hip resurfacing arthroplasty (HRA): A phantom study

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