Considering the noninvasiveness of the method and affordability of the hardware used in our system, it can be used in preoperative and postoperative measurements of pelvic orientation for supporting surgery planning and evaluation of treatment outcomes.
In this work, we show that the common guidelines used today for cup implantation can only be effectively applied to a small portion of the population. In most cases, it is crucial that the orientation of the cup is readjusted for the particular anatomy of the individual patient.
Background:The question whether Pelvic Tilt (PT) angles measured in the supine position are adequate for the alignment of the acetabular cup without an adjustment for anatomical differences between patients is of clinical importance. The aim of this work was to test for factors that can significantly affect PT angles.Methods:In the present retrospective cohort comparison, the PT angles of 12 Symptom-Free Young Subjects (SFYS) and 45 patients scheduled for Total Hip Arthroplasty (THA) were compared. The data was collected during two studies with the use of a novel smartphone-based navigated ultrasound measurement system. Multi-factorial analysis of variance was run to determine which factors significantly affect PT.Results:Body position (F= 126.65; P< 0.001) and group (SFYS vs. THA patients) (F= 17.52; P< 0.001) had significant main effects on PT. There was also a significant interaction between body position and group (F= 25.59; P< 0.001). The mean PT increased by 8.1° from an interiorly to a neutral tilted position (P< 0.001) and 21.4° from a neutral to a posteriorly tilted position (P< 0.001) with the transition from the supine into the upright position for the SFYS and THA patients, respectively.Conclusion:In both groups, PT changed significantly with a transition from the supine to the upright position. A position-dependent mean PT increase in the patient group showed that acetabular cup alignment based on PT in the supine position is not reliable without taking into consideration the inclination of the pelvis in standing position. This may lead to instability and dislocations.
Purpose The aim of the study was to assess potential endoprosthesis loosening in patients after revision total hip arthroplasty, based on monochromatic dual-energy computed tomography (DECT) images obtained with and without metal artifact reduction software (MARS) and comparison with the clinical examination and hip function. Materials and Methods Twenty-five consecutive patients underwent DECT examinations. Two monochromatic data sets were generated: with MARS (75-keV MARS) and without MARS (140-keV non-MARS) and evaluated for signs of loosening, using a dedicated radiological score. The Harris Hip Score (HHS) was used to evaluate patients' hip function. Results The mean radiological score for loosening in the non-MARS group was 16.2, in the MARS group 17.0 and was significantly higher (P < 0.001). Radiological loosening evaluation in non-MARS images correlated with the HHS score (ρ = 0.43, P = 0.03), whereas there was no correlation between MARS images and HHS (ρ = 0.15, P = 0.47). New MARS-related artifacts, which hinder implant-bone interface evaluation, were found in 75-keV MARS images (“pseudo-loosening” in 33 of 34 prostheses, “ground-glass blurring” in 20 of 32). Conclusions High-energy monochromatic DECT images are superior to low-energy DECT MARS images in assessment of the potential loosening and correlate better with the clinical examination outcomes. For revision total hip arthroplasty evaluation, 2 data sets should be assessed inseparably because of extra artifacts in MARS images.
SUMMARYWstęp. Ce lem pra cy by ła oce na kon tak tu ko szy pa new ko wych Re con Shell z pod ło żem kost nym, uży tych w cza sie za bie gów en do pro te zo pla sty ki re wi zyj nej sta wu bio dro we go. Ba da nia ra dio lo gicz ne prze pro wa dzo no z wy ko rzy staniem wie lo ener ge tycz nej to mo gra fii kom pu te ro wej.Ma te riał i me to dy. W ni niej szej pra cy, na ma te ria le 10 pa cjen tów pod da nych za bie go wi im plan ta cji re wi zyj nego ko sza pa new ko we go ty pu Burch -Schne ide ra (Re con Shell fir my Aescu lap), do ko na li śmy pró by oce ny ich osa dzenia z za sto so wa niem dwóch me tod. Dzię ki ana li zie ska nów to mo gra fii kom pu te ro wej dwu ener ge tycz nej, uda ło się oce nić kon takt po mię dzy im plan tem re wi zyj nym a zrę bem kost nym.Wy ni ki. Po rów na nie obu me tod oce ny da ło od mien ne wy ni ki. Oce na ba zu ją ca na po dzia le pa new ki na stre fę obcią ża ną i nie ob cią ża ną (z uwzględ nie niem mo co wa nia śru ba mi) wy ka za ła brak pod par cia w stre fie prze no szą cej obcią że nia w 6 na 10 przy pad ków, a tyl ko je den po sia dał bez po śred ni kon takt z pod ło żem. Przy oce nie kon tak tu w punk tach mo co wa nia pier wot ne go ko sza pa new ko we go, tyl ko w jed nym przy pad ku ta kie go pod par cia nie za obser wo wa no, a w 5 przy pad kach kon takt był bez po śred ni. Za ob ser wo wa no brak ko re la cji wy ni ku ra dio lo gicz ne go z wyni kiem kli nicz nym opar tym na punk ta cji Har ri sa (Har ris Hip Sco re).Wnio ski. 1. Za sto so wa nie wie lo ener ge tycz nej to mo gra fii kom pu te ro wej (MARS) jest po moc ne w oce nie wy ni ków alo pla styk re wi zyj nych sta wów bio dro wych. 2. Wpro wa dze nie no wych tech nik ob ra zo wa nia w oce nie zabie gów re wi zyj nych wska zu je na ko niecz ność opra co wa nia no wych ujed no li co nych i do sto so wa nych do spe cy fi ki za bie gu me tod oce ny uzy ska nych wy ni ków.Słowa kluczowe: przeżycia panewki, wyniki czynnościowe, wyniki radiologiczne, tomografia komputerowa, MARS SUMMARYBackground. This study aimed to assess contact between Recon Shell reinforcement cages used in revision hip arthroplasty and the bony base. Radiographic examinations were performed with the use of multi-energy computed tomography.Material and methods. We tentatively assess the fixation of Burch-Schneider reinforcement cages (Recon Shell made by Aesculap company) implanted in 10 patients, using two methods of evaluation. An analysis of dual energy CT scans enabled us to assess contact between the reinforcement cages and the bony base.Results. The two methods of evaluation produced different results. The evaluation method based on the division of the acetabular component into a weight-bearing zone and a non-weight-bearing zone (accounting for screw fixation) showed lack of support in the weight-bearing zone in 6 out of 10 cases and direct contact with the implant bed in only one case. The assessment of contact at anchorage holes of reinforcement cages fixed at primary procedures revealed no such support in only one case and th...
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