Computed Tomography in the Assessment of Periacetabular Osteolysis

Leung, Serena B.; Naudie, Douglas D.R.; Kitamura, Nobuto; Walde, Tim Alexander; Engh, Charles A.

doi:10.2106/00004623-200503000-00017

Cited by 36 publications

(28 citation statements)

References 14 publications

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“…In our study, routine radiographs were used and not all patients had radiographs through 10 years. We believe that routine radiographs are sufficiently sensitive to detect clinically important osteolytic lesions, but we agree with literature that suggests CT scans offer more accuracy; we consider the CT to be indicated when surgical intervention is considered [12,17]. Finally, the six surgeons in this study were experienced with the implant systems used, and the results may not be similar to a wider, less experienced surgeon population.…”

Section: Discussionsupporting

confidence: 69%

High Survivorship With a Titanium-encased Alumina Ceramic Bearing for Total Hip Arthroplasty

DʼAntonio

Capello

Naughton

2013

Clin Orthop Relat Res

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Ceramic bearings for THA with a titanium-encased insert have high survivorship at 10 years followup and a fracture risk of 0.5%. We found at last followup on routine radiographs no evidence of osteolysis, and no patient has been revised for squeaking or has reported dissatisfaction with the clinical result because of noise. IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 69%

High Survivorship With a Titanium-encased Alumina Ceramic Bearing for Total Hip Arthroplasty

DʼAntonio

Capello

Naughton

2013

Clin Orthop Relat Res

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“…Osteolysis was defined as a new, sharply demarcated radiolucent area that was not present at six to 12 weeks post-operatively. 24 The Brooker classification 25 was used to assess heterotopic ossification as: I, islands of bone within the soft tissues about hip; II, bone spurs in pelvis or proximal end of femur leaving at least 1 cm between the opposing bone surfaces; III, bone spurs extending from pelvis or the proximal end of femur that reduce the space between the opposing bone surfaces to < 1 cm; and IV, radiological ankylosis of the hip. Any complications related to the surgery were noted.…”

Section: Methodsmentioning

confidence: 99%

The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component

Jack

Molloy

Walter

et al. 2013

The Bone & Joint Journal

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The practice of removing a well-fixed cementless femoral component is associated with high morbidity. Ceramic bearing couples are low wearing and their use minimises the risk of subsequent further revision due to the production of wear debris. A total of 165 revision hip replacements were performed, in which a polyethylene-lined acetabular component was revised to a new acetabular component with a ceramic liner, while retaining the well-fixed femoral component. A titanium sleeve was placed over the used femoral trunnion, to which a ceramic head was added. There were 100 alumina and 65 Delta bearing couples inserted. The mean Harris hip score improved significantly from 71.3 (9.0 to 100.0) pre-operatively to 91.0 (41.0 to 100.0) at a mean follow up of 4.8 years (2.1 to 12.5) (p < 0.001). No patients reported squeaking of the hip. There were two fractures of the ceramic head, both in alumina bearings. No liners were seen to fracture. No fractures were observed in components made of Delta ceramic. At 8.3 years post-operatively the survival with any cause of failure as the endpoint was 96.6% (95% confidence interval (CI) 85.7 to 99.3) for the acetabular component and 94.0% (95% CI 82.1 to 98.4) for the femoral component. The technique of revising the acetabular component in the presence of a well-fixed femoral component with a ceramic head placed on a titanium sleeve over the used trunnion is a useful adjunct in revision hip practice. The use of Delta ceramic is recommended.

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“…However, these schemes mainly rely on visual interpretation of anatomical landmarks, which may lead to a poor inter‐observer reliability and intra‐observer repeatability . The reliability increases when using three‐dimensional (3D) computer tomography (CT) scans instead of 2D radiographs, but there still remains a bias related to subjective interpretation . Furthermore, the current classification schemes are mainly descriptive and hence it remains difficult to transfer them into pre‐clinical testing, implant development, and to anticipate the exact amount of bone loss in pre‐operative planning .…”

mentioning

confidence: 99%

“…[4][5][6] The reliability increases when using three-dimensional (3D) computer tomography (CT) scans instead of 2D radiographs, but there still remains a bias related to subjective interpretation. 5,7,8 Furthermore, the current classification schemes are mainly descriptive and hence it remains difficult to transfer them into pre-clinical testing, implant development, and to anticipate the exact amount of bone loss in pre-operative planning. 9 Novel imaging techniques allow a 3D presentation of individual bone structures, but an objective and quantitative method to assess the bone defects is still not available.…”

mentioning

confidence: 99%

Method for quantitative assessment of acetabular bone defects

Hettich¹,

Schierjott

Ramm³

et al. 2018

Journal Orthopaedic Research

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The objective of the study was to suggest a novel quantitative assessment of acetabular bone defects based on a statistical shape model, validate the method, and present preliminary results. Two exemplary CT‐data sets with acetabular bone defects were segmented to obtain a solid model of each defect pelvis . The pathological areas around the acetabulum were excluded and a statistical shape model was fitted to the remaining healthy bone structures. The excluded areas were extrapolated such that a solid model of the native pelvis per specimen resulted (i.e., each pelvis without defect). The validity of the reconstruction was tested by a leave‐one‐out study. Validation results showed median reconstruction errors of 3.0 mm for center of rotation, 1.7 mm for acetabulum diameter, 2.1° for inclination, 2.5° for anteversion, and 3.3 mm 3 for bone volume around the acetabulum. By applying Boolean operations on the solid models of defect and native pelvis , bone loss and bone formation in four different sectors were assessed. For both analyzed specimens, bone loss and bone formation per sector were calculated and were consistent with the visual impression. In specimen_1 bone loss was predominant in the medial wall (10.8 ml; 79%), in specimen_2 in the posterior column (15.6 ml; 46%). This study showed the feasibility of a quantitative assessment of acetabular bone defects using a statistical shape model‐based reconstruction method. Validation results showed acceptable reconstruction accuracy, also when less healthy bone remains. The method could potentially be used for implant development, pre‐clinical testing, pre‐operative planning, and intra‐operative navigation. © 2018 The Authors. Journal of Orthopaedic Research ® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 9999:1–9, 2018.

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Computed Tomography in the Assessment of Periacetabular Osteolysis

Cited by 36 publications

References 14 publications

High Survivorship With a Titanium-encased Alumina Ceramic Bearing for Total Hip Arthroplasty

High Survivorship With a Titanium-encased Alumina Ceramic Bearing for Total Hip Arthroplasty

The use of ceramic-on-ceramic bearings in isolated revision of the acetabular component

Method for quantitative assessment of acetabular bone defects

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