Micromotion in knee arthroplasty

Ryd, Leif

doi:10.3109/17453678609157924

Cited by 38 publications

(12 citation statements)

References 118 publications

(140 reference statements)

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“…The limits of the 95% tolerance interval for precision did not exceed 0.09 mm and 0.14°. These values are within the reported range for RSA techniques (<0.1 to 0.7 mm for translations and 0.03° to 0.5° for rotations (Ryd 1986 , Snorrason and Kärrholm 1990 , Önsten et al 1995 , Kärrholm et al 1997 , Østgaard et al 1997 , Önsten et al 2001 )). Yet, CTSA does not rely on bone/implant markers and offers the user-friendliness of EBRA but with more accuracy.…”

Section: Discussionsupporting

confidence: 82%

Development and validation of an automated and marker-free CT-based spatial analysis method (CTSA) for assessment of femoral hip implant migration In vitro accuracy and precision comparable to that of radiostereometric analysis (RSA)

et al. 2015

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Background and purpose — We developed a marker-free automated CT-based spatial analysis (CTSA) method to detect stem-bone migration in consecutive CT datasets and assessed the accuracy and precision in vitro. Our aim was to demonstrate that in vitro accuracy and precision of CTSA is comparable to that of radiostereometric analysis (RSA).Material and methods — Stem and bone were segmented in 2 CT datasets and both were registered pairwise. The resulting rigid transformations were compared and transferred to an anatomically sound coordinate system, taking the stem as reference. This resulted in 3 translation parameters and 3 rotation parameters describing the relative amount of stem-bone displacement, and it allowed calculation of the point of maximal stem migration. Accuracy was evaluated in 39 comparisons by imposing known stem migration on a stem-bone model. Precision was estimated in 20 comparisons based on a zero-migration model, and in 5 patients without stem loosening.Results — Limits of the 95% tolerance intervals (TIs) for accuracy did not exceed 0.28 mm for translations and 0.20° for rotations (largest standard deviation of the signed error (SDSE): 0.081 mm and 0.057°). In vitro, limits of the 95% TI for precision in a clinically relevant setting (8 comparisons) were below 0.09 mm and 0.14° (largest SDSE: 0.012 mm and 0.020°). In patients, the precision was lower, but acceptable, and dependent on CT scan resolution.Interpretation — CTSA allows detection of stem-bone migration with an accuracy and precision comparable to that of RSA. It could be valuable for evaluation of subtle stem loosening in clinical practice.

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Section: Discussionsupporting

confidence: 82%

Development and validation of an automated and marker-free CT-based spatial analysis method (CTSA) for assessment of femoral hip implant migration In vitro accuracy and precision comparable to that of radiostereometric analysis (RSA)

et al. 2015

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“…Our radiographic results show a small remaining varus position of the tibial component and for the arthroplasty. This is not uncommon in other series [17,18]. Our patients had frequently the most advanced stages of the OA disease, which makes surgery more demanding.…”

Section: Discussionmentioning

confidence: 93%

Duracon Total Knee Replacement in Kuwait: A Clinical and Radiographic Analysis of52 Knees Followed for 2–5 Years

Al-Rowaih¹,

Pospula²,

Abdul-Moez³

et al. 1999

Med Princ Pract

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Objective: In this prospective clinical and radiological study results of 52 consecutive Duracon bicompartmental total knee arthroplasties in 37 patients with femorotibial arthrosis and rheumatoid arthritis with the average observation time of 3 (2–5) years were analyzed. Methods: The study includes 32 women (44 knees) and 5 men (8 knees) with a mean age of 60 years. Details of implant design and surgical technique were given. Two surgeons performed all the operations. The patients were evaluated by an unbiased observer. The Hospital for Special Surgery (HSS) score for both pre- and postoperative assessment was used. Results: The average initial HSS score of 44 (20–65) improved to 85 (60–99) after operation. By subjective assessment, 41 knees were excellent, 10 good and 1 knee had a fair result. There were no revisions. The mean postoperative flexion was 101° (80–120). The mean anteroposterior angle of the tibial component was 4° of the varus and the mean lateral angle was 3° of the posterior slope. The mean postoperative hip-knee-ankle deviation was 4° of the varus. Conclusion: In Kuwait, the cemented Duracon total knee arthroplasty without patellar resurfacing gave satisfactory clinical results after an intermediate follow-up period of 3 years.

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“…The other longitudinal study found that biomarker levels, specifically osteocalcin and cross-linked carboxyterminal telopeptide of type I collagen (ICTP), were elevated before implant migration as assessed by radiosteriometric analsysis (RSA) 18 . Early implant migration is considered a risk factor for late loosening 55 and, therefore, the authors concluded that early elevation in these biomarkers is predictive of future migration. In our study, patients were categorized based on routine radiographic analysis and therefore, biomarker levels in the current study relate directly to the clinical manifestation of osteolysis.…”

Section: Discussionmentioning

confidence: 99%

Discovery of biomarkers to identify peri‐implant osteolysis before radiographic diagnosis

Ross¹,

Deng

Fang

et al. 2018

Journal Orthopaedic Research

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Peri-implant osteolysis is commonly diagnosed after substantial bone loss has occurred, making revision surgery more challenging. The goal of the current study was to identify urinary biomarkers that differentiate total hip replacement patients who eventually develop osteolysis from patients who do not. We used a repository of 24-h urine samples collected prior to surgery and annually thereafter in 26 patients, 16 who developed osteolysis, and 10 who did not. We examined the markers at radiographic diagnosis, annually for 6 years preceding diagnosis, at the first post-operative sampling point, and pre-operatively. Patients in the osteolysis and non-osteolysis groups were matched according to time post-surgery and did not differ in the male:female ratio or age at surgery. Seven candidate biomarkers were measured, including free deoxypyridinoline (DPD), cross-linked N-telopeptides (NTX), interleukin-6 (IL-6), interleukin-8 (IL-8), osteoprotegerin (OPG), α-crosslaps (α-CTX), and β-crosslaps (β-CTX). As an individual biomarker, DPD demonstrated the highest ability to predict osteolysis, with an area under the curve (AUC) in Receiver Operating Characteristic (ROC) analyses of 0.844 at 6 years prior to diagnosis. A panel of α-CTX and IL-6 was able to identify at-risk patients with an AUC of 0.941 or greater at all post-operative time points and an AUC of 1.000 pre-operatively. The results demonstrate the potential of using non-invasive biomarkers to identify patients at risk for peri-implant osteolysis long before the emergence of radiographic signs. Further, the high accuracy of the pre-operative biomarker levels demonstrates the potential importance of pre-existing, patient-specific factors driving subsequent osteolysis. Study Design © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2754-2761, 2018.

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Micromotion in knee arthroplasty

Cited by 38 publications

References 118 publications

Development and validation of an automated and marker-free CT-based spatial analysis method (CTSA) for assessment of femoral hip implant migration In vitro accuracy and precision comparable to that of radiostereometric analysis (RSA)

Development and validation of an automated and marker-free CT-based spatial analysis method (CTSA) for assessment of femoral hip implant migration In vitro accuracy and precision comparable to that of radiostereometric analysis (RSA)

Duracon Total Knee Replacement in Kuwait: A Clinical and Radiographic Analysis of52 Knees Followed for 2–5 Years

Discovery of biomarkers to identify peri‐implant osteolysis before radiographic diagnosis

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