Radiostereometric Analysis: The Hip

Böttner, Friedrich; Su, Edwin P.; Nestor, Bryan J.; Azzis, B.; Sculco, Thomas P.; Bostrom, Mathias P.

doi:10.1007/s11420-005-0114-2

Cited by 35 publications

(22 citation statements)

References 42 publications

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“…For hip stems the prediction of failure of implants is due to the shape of the implant. Migration exceeding 0.85 mm within the first six months is a predictor for implant failure for anatomical cemented stems [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

Brodén

Olivecrona

Maguire

et al. 2016

BioMed Research International

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Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting.

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Section: Discussionmentioning

confidence: 99%

Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

Brodén

Olivecrona

Maguire

et al. 2016

BioMed Research International

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“…The initial migration pattern of the HAC stem could be compared to the migration pattern of cemented prostheses where the design (i.e the collar, cone, and/or specific geometric shape) provides an immediate stability, known as “shape closed” ( Bottner et al 2005 ) for cemented prostheses. The movement pattern of the Active stem, however, is more similar to that of the expression “force closed” in cemented prostheses.…”

Section: Discussionmentioning

confidence: 99%

“…Here, the prosthesis is designed to migrate into the cement mantle—or in the case of an uncemented prosthesis, to “settle in” under the force of rotation and axial compression—to the position that it will be osseointegrated in. The amount of migration before osseointegration is thought to be influenced by the amount of press fit, stem positioning during surgery, stem size in relation to femur size, the shape of the femur, the presence or absence of osteoporosis, stem geometry and coating, and external factors such as postoperative axial compression and rotation ( Bottner et al 2005 , Campbell et al 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Design modifications of the uncemented Furlong hip stem result in minor early subsidence but do not affect further stability

2014

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Background and purpose —Even small design modifications of uncemented hip stems may alter the postoperative 3-D migration pattern. The Furlong Active is an uncemented femoral stem which, in terms of design, is based on its precursor—the well-proven Furlong HAC—but has undergone several design changes. The collar has been removed on the Active stem along with the lateral fin; it is shorter and has more rounded edges in the proximal part. We compared the migration patterns of the uncemented Furlong HAC stem and the modified Furlong Active stem in a randomized, controlled trial over 5 years using radiostereometry (RSA).Patients and methods —50 patients with primary osteoarthritis were randomized to receive either the HAC stem or the Active stem. The patients underwent repeated RSA examinations (postoperatively, at 3 months, and after 1, 2, and 5 years) and conventional radiography, and they also filled out hip-specific questionnaires.Results —During the first 3 months, the collarless Active stem subsided to a greater extent than the collar-fitted HAC stem (0.99 mm vs. 0.31 mm, p = 0.05). There were, however, no other differences in movement measured by RSA or in clinical outcome between the 2 stems. After 3 months, both stem types had stabilized and almost no further migration was seen.Interpretation —The Active stem showed no signs of unfavorable migration. Our results suggest that the osseointegration is not compromised by the new design features.

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“…In many patients (roughly 10,000 in Sweden alone [ 6 ]) tantalum beads were implanted into the bone and attached to or inserted into the prosthesis for assessment of joint replacements with RSA. However, RSA requires calibration cages, radiology facilities with two X-ray machines for simultaneous acquisition of two X-ray images, specialized software, and trained personnel [ 7 ]. The number of hospitals capable of this analysis is limited; thus alternative techniques, for following these patients over time, such as three-dimensional (3D) computed tomography (CT), should be considered.…”

Section: Introductionmentioning

confidence: 99%

Are CT Scans a Satisfactory Substitute for the Follow-Up of RSA Migration Studies of Uncemented Cups? A Comparison of RSA Double Examinations and CT Datasets of 46 Total Hip Arthroplasties

Otten

Maguire

Noz

et al. 2017

BioMed Research International

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As part of the 14-year follow-up of a prospectively randomized radiostereometry (RSA) study on uncemented cup fixation, two pairs of stereo radiographs and a CT scan of 46 hips were compared. Tantalum beads, inserted during the primary operation, were detected in the CT volume and the stereo radiographs and used to produce datasets of 3D coordinates. The limit of agreement between the combined CT and RSA datasets was calculated in the same way as the precision of the double RSA examination. The precision of RSA corresponding to the 99% confidence interval was 1.36°, 1.36°, and 0.60° for X-, Y-, and Z-rotation and 0.40, 0.17, and 0.37 mm for X-, Y-, and Z-translation. The limit of agreement between CT and RSA was 1.51°, 2.17°, and 1.05° for rotation and 0.59, 0.56, and 0.74 mm for translation. The differences between CT and RSA are close to the described normal 99% confidence interval for precision in RSA: 0.3° to 2° for rotation and 0.15 to 0.6 mm for translation. We conclude that measurements using CT and RSA are comparable and that CT can be used for migration studies for longitudinal evaluations of patients with RSA markers.

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Radiostereometric Analysis: The Hip

Cited by 35 publications

References 42 publications

Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

Design modifications of the uncemented Furlong hip stem result in minor early subsidence but do not affect further stability

Are CT Scans a Satisfactory Substitute for the Follow-Up of RSA Migration Studies of Uncemented Cups? A Comparison of RSA Double Examinations and CT Datasets of 46 Total Hip Arthroplasties

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