Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement

Biedermann, R.; Krismer, Martin; Stöckl, B.; Mayrhofer, P.; Ornstein, Ewald; Franzén, Herbert

doi:10.1302/0301-620x.81b2.0810266

Cited by 84 publications

(103 citation statements)

References 20 publications

(20 reference statements)

Supporting

Mentioning

103

Contrasting

Order By: Relevance

“…The ability of early migration measurements to predict later aseptic loosening has been established [5,13,16,19]. Marker-based RSA is considered the gold standard for measurement of implant migration, and it has been used as a standard of comparison for other radiographic methods, such as the Sutherland, Wetherell, and Sulzer methods or EBRA (Ein-Bild-Röntgen-Analyse, single-image roentgen analysis) [2,6]. Possible disadvantages of the marker-based RSA method, such as prosthesis marker occlusion or increasing cost of additional implant marking, could be compensated by the new model-based method [10,14,26].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Model-based RSA Contour Reduction in a Typical Clinical Application

Hurschler

Seehaus

Emmerich

et al. 2008

Clin Orthop Relat Res

View full text Add to dashboard Cite

Marker-based roentgen stereophotogrammetric analysis (RSA) is an accurate method for measuring in vivo implant migration, which requires attachment of tantalum markers to the implant. Model-based RSA allows migration measurement without implant markers; digital pose estimation, which can be thought of as casting a shadow of a surface model of the implant into the stereoradiographs, is used instead. The number of surface models required in a given clinical study depends on the number of implanted sizes and design variations of prostheses. Contour selection can be used to limit pose estimation to areas of the prosthesis that do not vary with design, reducing the number of surface models required. The effect of contour reduction on the accuracy of the model-based method was investigated using three different contour selection schemes on tibial components in 24 patients at 3 and 6 month followup. The agreement interval (mean ± 2 standard deviations), which bounds the differences between the marker-based and model-based methods with contour reduction was smaller than -0.028 ± 0.254 mm. The data suggest that contour reduction does not result in unacceptable loss of model-based RSA accuracy, and that the model-based method can be used interchangeably with the marker-based method for measuring tibial component migration.

show abstract

Section: Discussionmentioning

confidence: 99%

Accuracy of Model-based RSA Contour Reduction in a Typical Clinical Application

Hurschler

Seehaus

Emmerich

et al. 2008

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

“…Two of us (KT, RW) measured acetabular component abduction and anteversion angles using Einzel-Bild-Röntgen-Analysis cup software, Version 2003 (University of Innsbruck, Innsbruck, Austria) [13,26], a method for which the interobserver reliability is high (Cronbach a coefficient of 0.84) [12]. Contact patch to rim distance was computed as suggested by Langton et al [25].…”

Section: Methodsmentioning

confidence: 99%

Socket Position Determines Hip Resurfacing 10-Year Survivorship

Amstutz

Duff

Johnson

2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a surgeon learning curve. Owing to failures with early surgical techniques, we developed a second-generation technique to address those failures. However, it is unclear whether the techniques affected the long-term risk factors. Questions/purposes We (1) determined survivorship for hips implanted with the second-generation cementing technique; (2) identified the risk factors for failure in these patients; and (3) determined the effect of the dominant risk factors on the observed modes of failure. Methods We retrospectively reviewed the first 200 hips (178 patients) implanted using our second-generation surgical technique, which consisted of improvements in cleaning and drying the femoral head before and during cement application. There were 129 men and 49 women. Component orientation and contact patch to rim distance were measured. We recorded the following modes of failure: femoral neck fracture, femoral component loosening, acetabular component loosening, wear, dislocation, and sepsis. The minimum followup was 25 months (mean, 106.5 months; range, 25-138 months). Results Twelve hips were revised. Kaplan-Meier survivorship was 98.0% at 5 years and 94.3% at 10 years. The only variable associated with revision was acetabular component position. Contact patch to rim distance was lower in hips that dislocated, were revised for wear, or were revised for acetabular loosening. The dominant modes of failure were related to component wear or acetabular component loosening. Conclusions Acetabular component orientation, a factor within the surgeon's control, determines the long-term success of our current hip resurfacing techniques. Current techniques have changed the modes of failure from aseptic femoral failure to wear or loosening of the acetabular component.

show abstract

“…The association between early implant stability and long-term survivorship is well established for a variety of stem designs [23,28,38,43], with the gold standard in evaluating initial implant stability being radiostereometric analysis (RSA) [8,39]. Another validated technique to measure implant migration is Ein-Bild-Roentgen-Analysefemoral component analysis (EBRA-FCA) [3,27], which also allows accurate measurement of femoral stem subsidence without the need for tantalum markers [4] and can be performed retrospectively using standard pelvic radiographs. EBRA-FCA has an accuracy of better than ± 1.5 mm (95% CI) when compared to RSA, a Cronbach alpha coefficient of 0.84 [3], a specificity of 100%, and sensitivity of 79% [3].…”

Section: Introductionmentioning

confidence: 99%

“…Another validated technique to measure implant migration is Ein-Bild-Roentgen-Analysefemoral component analysis (EBRA-FCA) [3,27], which also allows accurate measurement of femoral stem subsidence without the need for tantalum markers [4] and can be performed retrospectively using standard pelvic radiographs. EBRA-FCA has an accuracy of better than ± 1.5 mm (95% CI) when compared to RSA, a Cronbach alpha coefficient of 0.84 [3], a specificity of 100%, and sensitivity of 79% [3]. Using a cutoff value of 1.5 mm for femoral stem subsidence in the first 2 years, EBRA-FCA has a sensitivity of 69%, specificity of 80%, and accuracy of 79% in predicting implant failure [28].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High Incidence of Migration with Poor Initial Fixation of the Accolade® Stem

White

Carsen

Rasuli

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Numerous cementless femoral stem design variations are in clinical use. Because initial implant instability and micromotion are associated with aseptic loosening of the femoral component, migration analysis provides an early assessment of implant survivorship. Questions/purposes We determined the (1) migration pattern of the Accolade 1 cementless femoral stem; (2) clinical factors predisposing to stem migration; (3) selfreported patient outcomes; and (4) our current rate of aseptic stem loosening. Methods We retrospectively analyzed 81 femoral stems for aseptic migration using Ein-Bild-Roentgen-Analysefemoral component analysis. Postoperatively, patients completed the WOMAC and SF-12 questionnaires. We assessed radiographic factors potentially associated with subsidence: indices of bone shape and quality, canal fill of the implant, and radiographic signs of loosening. Minimum followup was 24 months (mean, 29 months; range, 24-48 months). Results The average subsidence at 24 months was 1.3 mm (range, 0-1.5 mm). In the first 2 years, 36% of stems subsided more than 1.5 mm. Large stem size was associated with subsidence. Radiolucent lines ([ 1.5 mm in three zones) were present in 10% of stems and associated with lower questionnaire scores. The 5-year survivorship for aseptic loosening of the 367 stems was 97% with revision as end point and 95% for radiographic failure.

show abstract

Accuracy of EBRA-FCA in the measurement of migration of femoral components of total hip replacement

Cited by 84 publications

References 20 publications

Accuracy of Model-based RSA Contour Reduction in a Typical Clinical Application

Accuracy of Model-based RSA Contour Reduction in a Typical Clinical Application

Socket Position Determines Hip Resurfacing 10-Year Survivorship

High Incidence of Migration with Poor Initial Fixation of the Accolade® Stem

Contact Info

Product

Resources

About