Notes on the use and interpretation of radiostereometric analysis

Derbyshire, Brian; Prescott, R. J.; Porter, Martyn

doi:10.1080/17453670902807474

Cited by 59 publications

(50 citation statements)

References 20 publications

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“…A sample size of 25 to 30 patients is reportedly sufficient for the screening of implants using RSA 10,25,26 ; however, the more ‘at risk’ events that are reported, the greater the sample size that is required to be confident that the results obtained from the study groups are generalisable to the population. 48 However, the study is strengthened in that both the modified implant and its predecessor were screened under the same conditions in a randomised controlled trial, which may mitigate the problem of having a small sample size to some degree. Furthermore, some confidence in the validity of the RSA data from this study can be gained because of the similarities in migration, particularly MTPM, with other cemented tibial components.…”

Section: Discussionmentioning

confidence: 99%

Does a new knee design perform as well as the design it replaces?

Molt

Ljung

2012

Bone & Joint Research

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ObjectivesThe objective of this study was to compare the early migration characteristics and functional outcome of the Triathlon cemented knee prosthesis with its predecessor, the Duracon cemented knee prosthesis (both Stryker).MethodsA total 60 patients were prospectively randomised and tibial component migration was measured by radiostereometric analysis (RSA) at three months, one year and two years; clinical outcome was measured by the American Knee Society score and the Knee Osteoarthritis and Injury Outcome Score.ResultsThere were no statistically significant differences in rotation or translation around or along the three coordinal axes, or in the maximum total point motion (MTPM) during the two-year follow-up.ConclusionsThe Triathlon cemented knee prosthesis has similar early stability and is likely to perform at least as well as the Duracon cemented knee prosthesis over the longer term.

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Section: Discussionmentioning

confidence: 99%

Does a new knee design perform as well as the design it replaces?

Molt

Ljung

2012

Bone & Joint Research

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“…The high sensitivity of the RSA measurement technique, in conjunction with the ability to extrapolate results of short-term average linear wear rate to the average longterm linear wear rate for a population, makes this a useful tool for screening newly introduced prostheses [13,29,49]. Despite this, the RSA technique has limitations in accuracy and precision [4,7,51] that make it challenging to measure very small amounts of wear that are less than the detection threshold.…”

Section: Discussionmentioning

confidence: 99%

Second-generation Highly Cross-linked X3™ Polyethylene Wear: A Preliminary Radiostereometric Analysis Study

Campbell

Field

Callary

2010

Clinical Orthopaedics &Amp; Related Research

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Background First-generation highly cross-linked polyethylene liners have reduced the incidence of wear particleinduced osteolysis. However, failed acetabular liners have shown evidence of surface cracking, mechanical failure, and oxidative damage. This has led to the development of second-generation highly cross-linked polyethylene, which has improved wear and mechanical properties and resistance to oxidation in vitro. Owing to its recent introduction, there are no publications describing its clinical performance. Questions/purposes We assessed early clinical wear of a second-generation highly cross-linked polyethylene liner and compared its clinical performance with the published results of hip simulator tests and with first-generation highly cross-linked polyethylene annealed liners. Patients and Methods Twenty-one patients were enrolled in a prospective cohort study. Clinical outcome and femoral head penetration were measured for 19 patients at 6 months and 1 and 2 years postoperatively. Results The median proximal head penetration was 0.009 mm and 0.024 mm at 1 and 2 years, respectively. The median two-dimensional (2-D) head penetration was 0.083 mm and 0.060 mm at 1 and 2 years, respectively. The median proximal wear rate between 1 and 2 years was 0.015 mm/year. Conclusions The wear rate calculated was similar to the in vitro wear rate reported for this material; however, it was less than the detection threshold for this technique. Although longer followup is required for wear to reach a clinically quantifiable level, this low level of wear is encouraging for the future clinical performance of this material.

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“…The accuracy and precision were calculated according to the recommendations [6,21]. The accuracy was calculated Mean difference = paired difference between micrometer-measured actual displacements and RSA-measured values; accuracy = t 9 SD/H2.…”

Section: Statistical Analysesmentioning

confidence: 99%

Is Model-based Radiostereometric Analysis Suitable for Clinical Trials of a Cementless Tapered Wedge Femoral Stem?

Nazari-Farsani

Finnilä

Moritz

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background In clinical trials of THA, model-based radiostereometric analysis (RSA) techniques may be less precise than conventional marker-based RSA for measurement of femoral stem rotation. We verified the accuracy and clinical precision of RSA based on computeraided design models of a cementless tapered wedge femoral stem. Questions We asked: (1) Is the accuracy of model-based RSA comparable to that of marker-based RSA? (2) What is the clinical precision of model-based RSA?Methods Model-based RSA was performed using combined three-dimensional computer-aided design models of the stem and head provided by the implant manufacturer. The accuracy of model-based RSA was compared with that of marker-based RSA in a phantom model using micromanipulators for controlled translation in three axes (x, y, z) and rotation around the y axis. The clinical precision of model-based RSA was evaluated by double examinations of patients who had arthroplasties (n = 24) in an ongoing trial. The clinical precision was defined as being at an acceptable level if the number of patients needed for a randomized trial would not differ from a trial done with conventional marker-based RSA (15-25 patients per group).Results The accuracy of model-based RSA was 0.03 mm for subsidence (translation along the y axis) (95% CI for the difference between RSA measurements and actual displacement measured with micrometers, À0.03-0.00) and 0.39°for rotation around the y axis (95% CI, À0.41 to À0.06). The accuracy of marker-based RSA was 0.06 mm for subsidence (95% CI, À0.04-0.01; p = 0.728 compared with model-based RSA) and 0.18°for the y axis rotation (95% CI, À0.23 to À0.07; p = 0.358). The clinical precision of model-based RSA was 0.14 mm for subsidence (95% CI for the difference between double examinations, À0.02-0.04) and 0.79°for the y axis rotation (95% CI, À0.16-0.18).Conclusions The accuracy of model-based RSA for measurement of the y axis rotation was not quite as high as that of marker-based RSA, but its clinical precision is at an acceptable level. Clinical relevance Model-based RSA may be suitable for clinical trials of cementless tapered wedge femoral stem designs.

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Notes on the use and interpretation of radiostereometric analysis

Cited by 59 publications

References 20 publications

Does a new knee design perform as well as the design it replaces?

Does a new knee design perform as well as the design it replaces?

Second-generation Highly Cross-linked X3™ Polyethylene Wear: A Preliminary Radiostereometric Analysis Study

Is Model-based Radiostereometric Analysis Suitable for Clinical Trials of a Cementless Tapered Wedge Femoral Stem?

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