Understanding, Interpreting and Reporting a Total Hip Arthroplasty Radiograph

Chan, Josephine; Khoriati, Al-Achraf; Chiang, Chu-Hao; Al-Hadithy, Nawfal

doi:10.4172/2161-0533.1000243

Cited by 5 publications

(8 citation statements)

References 42 publications

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“…However, it can be interpreted as complete white-out or a Mach-effect indicating edge enhancement between areas of different densities on radiological images. 34 , 49 Cement fractures and osteolytic lesions were not observed in any THA and may indicate low implant wear at 24 months. High-viscosity cement was used in the present study, which possibly created higher pressure and subsequent better penetration into corticocancellous bone.…”

Section: Discussionmentioning

confidence: 94%

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Sevaldsen

Husby

Lian

et al. 2022

The Bone & Joint Journal

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Aims Highly polished stems with force-closed design have shown satisfactory clinical results despite being related to relatively high early migration. It has been suggested that the minimal thickness of cement mantles surrounding the femoral stem should be 2 mm to 4 mm to avoid aseptic loosening. The line-to-line cementing technique of the femoral stem, designed to achieve stem press-fit, challenges this opinion. We compared the migration of a highly polished stem with force-closed design by standard and line-to-line cementing to investigate whether differences in early migration of the stems occur in a clinical study. Methods In this single-blind, randomized controlled, clinical radiostereometric analysis (RSA) study, the migration pattern of the cemented Corail hip stem was compared between line-to-line and standard cementing in 48 arthroplasties. The primary outcome measure was femoral stem migration in terms of rotation and translation around and along with the X-, Y-, and Z- axes measured using model-based RSA at three, 12, and 24 months. A linear mixed-effects model was used for statistical analysis. Results Results from mixed model analyses revealed a lower mean retroversion for line-to-line (0.72° (95% confidence interval (CI) 0.38° to 1.07°; p < 0.001), but no significant differences in subsidence between the techniques (-0.15 mm (95% CI -0.53 to 0.227; p = 0.429) at 24 months. Radiolucent lines measuring < 2 mm wide were found in three and five arthroplasties cemented by the standard and line-to-line method, respectively. Conclusion The cemented Corail stem with a force-closed design seems to settle earlier and better with the line-to-line cementing method, although for subsidence the difference was not significant. However, the lower rate of migration into retroversion may reduce the wear and cement deformation, contributing to good long-term fixation and implant survival. Cite this article: Bone Joint J 2022;104-B(1):19–26.

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Section: Discussionmentioning

confidence: 94%

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Sevaldsen

Husby

Lian

et al. 2022

The Bone & Joint Journal

View full text Add to dashboard Cite

show abstract

“…Secondary outcome measures included diagnosis for revision and radiographic analysis (osteotomy union, polyethylene wear, osteolysis, and implant loosening) performed by 2 independent observers and confirmed by the senior author. If osteolysis was found around the acetabular or femoral components, the zones and sizes were recorded according to the Gruen, Johnston, and Charnley zones [ 9 ]. Acetabular wear was measured and recorded as the asymmetric distance between the head of the prosthesis and the acetabular rim [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Total Hip Arthroplasty With Subtrochanteric Osteotomy for Developmental Hip Dysplasia: A Long-term Follow-up Study

Palumbo¹,

Salomon²,

Sullivan³

et al. 2022

Arthroplasty Today

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“…Radiography is relied upon to assess hip and knee arthroplasty and is usually preferred over other imaging techniques [ 1 ]. An adequate radiograph should detail implant type and position, fixation technique, zones of radiolucency and bone remodeling, soft tissue anomaly, implant wear and related bony defects and fractures [ 2 ]. Inadequate radiographs may pose challenge to a clinician in interpreting finer details, leading to missed diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Review of Arthroplasty Radiographs: How to Define an Adequate Radiograph

Ahmad¹,

Al-Ashqar

Khan³

et al. 2022

Cureus

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IntroductionAdequacy of postoperative hip and knee radiographs has a direct impact on its interpretation. We undertook a quality improvement project by creating local standards to meet the arthroplasty team expectations for a satisfactory radiograph. The purposes of the study are 1. Assessment of the adequacy of radiographs according to defined criteria, and 2. Correlation of system and patient factors with inadequate radiographs. MethodsStage I: We conducted a single centre, retrospective audit to check the adequacy of a postoperative radiography following a total hip or knee replacement. A total of 100 radiographs were assessed against the nine criteria laid out with the consensus of orthopaedic surgeons and radiologists.Stage II: We created a quality improvement proforma for use in the radiology department. We re-assessed 100 radiographs during the second cycle against the nine criteria to check the adequacy of hip and knee arthroplasty radiographs, ResultsStage I: Of 100 radiographs, 51 were from the knee and 49 from the hip arthroplasty group. Sixty-nine radiographs were adequate considering overall criteria, and 31 radiographs were inadequate. The inadequacy in radiographs was related to the visibility of prosthesis, cement or relevant anatomy.Stage II: We created a quality improvement performa for use in radiology department, highlighting the nine initial criteria. One hundred radiographs of hip and knee arthroplasty were re-assessed. Overall, 84 radiographs fulfilled the criteria of being adequate. ConclusionAdequacy of knee and hip arthroplasty radiographs is essential in picking up pathologies that can be missed otherwise. We present simple criteria to improve the adequacy of x-ray and prevent repetition of radiographs.

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Understanding, Interpreting and Reporting a Total Hip Arthroplasty Radiograph

Cited by 5 publications

References 42 publications

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Total Hip Arthroplasty With Subtrochanteric Osteotomy for Developmental Hip Dysplasia: A Long-term Follow-up Study

Retrospective Review of Arthroplasty Radiographs: How to Define an Adequate Radiograph

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