Superior accuracy of model-based radiostereometric analysis for measurement of polyethylene wear

Stilling, Maiken; Kold, Søren; Raedt, Sepp de; Andersen, Niels Trolle; Rahbek, Ole; Søballe, Kjeld

doi:10.1302/2046-3758.18.2000041

Cited by 35 publications

(48 citation statements)

References 38 publications

(54 reference statements)

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“…The RMSE reported for the medial and proximal axes in our study were very low and similar to four other studies that used UmRSA and a model‐based RSA software (Table ). The model‐based RSA software had higher errors in the anterior axis and resultant 3D measurements . Previously, the accuracy of the RSA method was improved when more markers were used to represent the acetabular component but this was not the case in our study.…”

Section: Discussionsupporting

confidence: 88%

“…Our results are compared to those of studies that examined the accuracy of radiographic measurements of FHP by comparing these to known movements of hip phantom models with a metal‐backed acetabular component (Tables and ). The only other study that has compared the accuracy of RSA to other methods found two model‐based RSA software programs to be more accurate and precise than PolyWare 2D FHP measurements . Our results confirm that the accuracy of RSA is superior to that of PolyWare but we found that the variability (RMSE) of PolyWare 2D FHP measurements (0.08 mm) is much lower than that previously reported by Stilling et al (0.47 mm) .…”

Section: Discussionsupporting

confidence: 84%

“…For example, the mean error of 3D FHP measurements ranges from 0.005 to 0.24 mm for HAS and from 0.022 to 0.34 mm for PolyWare. While RSA is widely regarded as the gold standard measurement method, only one study has compared the accuracy of RSA to that of another software program, namely PolyWare, using an in vitro phantom model . A review of some radiographic wear measurement methods attempted to adjust for the different statistical presentations of accuracy by calculating the RMSE for each method from each study's data, reporting an RMSE of 0.065 for RSA, 0.033 for HAS, and 0.025 mm for PolyWare …”

mentioning

confidence: 99%

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Accuracy of methods to measure femoral head penetration within metal-backed acetabular components

et al. 2016

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A number of different software programs are used to investigate the in vivo wear of polyethylene bearings in total hip arthroplasty. With wear rates below 0.1 mm/year now commonly being reported for highly cross-linked polyethylene (XLPE) components, it is important to identify the accuracy of the methods used to measure such small movements. The aims of this study were to compare the accuracy of current software programs used to measure two-dimensional (2D) femoral head penetration (FHP) and to determine whether the accuracy is influenced by larger femoral heads or by different methods of representing the acetabular component within radiostereometric analysis (RSA). A hip phantom was used to compare known movements of the femoral head within a metal-backed acetabular component to FHP measured radiographically using RSA, Hip Analysis Suite (HAS), PolyWare, Ein Bild Roentgen Analyse (EBRA), and Roentgen Monographic Analysis Tool (ROMAN). RSA was significantly more accurate than the HAS, PolyWare, and ROMAN methods when measuring 2D FHP with a 28 mm femoral head. Femoral head size influenced the accuracy of HAS and ROMAN 2D FHP measurements, EBRA proximal measurements, and RSA measurements in the proximal and anterior direction. The use of different acetabular reference segments did not influence accuracy of RSA measurements. The superior accuracy and reduced variability of RSA wear measurements allow much smaller cohorts to be used in RSA clinical wear studies than those utilizing other software programs. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:988-996, 2017.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

mentioning

confidence: 99%

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Accuracy of methods to measure femoral head penetration within metal-backed acetabular components

et al. 2016

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“…SD, set of bias standard deviation; sr, repeatability standard deviation; r, repeatability 95% limit; sR, reproducibility standard deviation; R, reproducibility 95% limit. 15 Simple X-Ray (manual): uniradiographic Cemented 1.251 * N/A Kang et al 16 Simple X-Ray (manual): Livermore technique Cementless 0.237 * N/A Kang et al 16 Simple X-Ray (manual): Dorr & Wan technique Cementless 0.210 * N/A Martell et al 19 Martell (computer-assisted) Cementless 0.033 ** 0.072 ** Bragdon et al 9 RSA Cementless 0.065 ** 0.067 ** Stilling et al 12 Polyware (computer-assisted): 2D wear measures Cementless 0.335 0.076 Crockarell et al 18 ROMAN (computer-assisted) Cementless differently specified 0.325 Jedenmalm et al 17 CT WEAR MEASUREMENT FOR CEMENTED HIP COMPONENTS less expensive, and less cumbersome than RSA. It does not necessitate the intra-operative insertion of markers and can be used retrospectively in any series, while RSA can only be applied to a limited number of patients in prospective clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…For historical comparison purposes, we also computed our results using previously published methods for calculating accuracy and precision. Precision was therefore presented as suggested in previous ASTM177–10 standards, equivalent to 1.96 multiplied by the standard deviation of a set of paired measurements, and accuracy as a root mean square error considering a constant bias …”

Section: Methodsmentioning

confidence: 99%

Validation of a computer‐assisted method for measurement of radiographic wear in total hip arthroplasty using all polyethylene cemented acetabular components

Langlois

Zaoui

Scemama

et al. 2015

Journal Orthopaedic Research

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Although cemented all polyethylene (PE) cups have been routinely used in total hip arthroplasty for decades, no computer-assisted method for measurement of radiographic wear has ever been specifically validated for these implants. Using a validated hip phantom model, AP plain hip radiographs were obtained consecutively for eight simulated wear positions. A version of Martell's Hip Analysis Suite software dedicated to all polyethylene sockets was used by three different examiners of varied experience. Bias (mean, standard deviation and 95% confidence interval limit), repeatability (standard deviation and 95% limit) and reproducibility (standard deviation and 95% limit) for two-dimensional wear measurements were assessed, as recommended by the current ASTM guidelines. Using this protocol, the dedicated software showed an overall mean bias of 0.089 AE 0.060 mm (mean AE SD), and 0.118 mm for 95% CI limit. Repeatability (intra examiner) standard deviation and 95% limit were respectively 0.106 mm and 0.292 mm. Reproducibility (inter examiner) standard deviation and 95% limit were respectively 0.112 mm and 0.308 mm. Martell Hip Analysis for all PE cemented cups is a reliable and low-cost instrument in the assessment of wear, despite being less precise than its original version dedicated to cementless components. Keywords: total hip replacement; polyethylene wear; error measurement; precision measurement; accuracy measurementThe number of total hip arthroplasty (THA) surgical procedures in the United States is expected to reach 572,000 per year by the year 2030.1 As this procedure is getting more and more reliable, an increasing number of younger patients are now THA candidates. However it has been shown that this population might present accelerated polyethylene wear. To solve this problem, many refinements in polyethylene (PE) processing have been proposed including cross-linking with or without the addition of an anti-oxidant such as vitamin E.2 These have showed excellent results in hip simulator studies and in clinical practice, leading to a continued interest in using PE in THA. In addition, there is increasing recent evidence that cemented fixation of acetabular components might be more reliable than that of cementless components beyond the first postoperative decade. 3,4 This phenomenon could be related to accelerated PE wear in uncemented compared to cemented acetabular components. 5As polyethylene wear remains a major factor in failure of THA through particle-induced osteolysis and resultant aseptic loosening, 6 new challenges for in vivo measurement of wear in THA implants are a matter of major concern. Indeed, wear measurement is critical to adequately evaluate new materials and can also help to decide when to monitor patients more closely and when to consider revision surgery. Though various radiographic methods have been developed to measure polyethylene wear, including manual or computerassisted plain radiography, two-or three-dimensional techniques, or radiostereometric analysis, 7,8 to the bes...

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Validation of In Vivo Linear and Volumetric Wear Measurement for Reverse Total Shoulder Arthroplasty Using Model‐Based Radiostereometric Analysis

Kleut

Yuan

Athwal

et al. 2019

Journal Orthopaedic Research

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Presently, polyethylene wear measurement of reverse total shoulder arthroplasty (rTSA) is restricted to in vitro, in silico, and retrieval analysis, with no method for the quantification of in vivo wear of well-functioning implants. The purpose of this study was to validate the use of model-based radiostereometric analysis (MBRSA) as a measurement tool for in vivo rTSA wear using a phantom setup. Six additively manufactured polyethylene inserts were fabricated, one unworn control and five to represent known wear patterns, and individually fit within the rTSA components. Each insert was imaged using standard radiostereometric techniques and analyzed using MBRSA. From the position and orientation estimation provided by MBRSA, a micro-computed tomography model of the control insert was virtually placed within the metaphyseal tray. The apparent intersection of the glenosphere into the insert was recorded as wear. This method enables wear measurements with a linear precision of 0.21 mm and a bias of 0.36 ± 0.13 mm, and a volumetric precision of 49.3 mm 3 , with a bias of 48.9 ± 24.3 mm 3 . This technique allows for the in vivo measurement of polyethylene wear without the requirement of marker beads or baseline radiographs, expanding the potential for in vivo wear measurements to larger populations and retrospective analysis.

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Superior accuracy of model-based radiostereometric analysis for measurement of polyethylene wear

Cited by 35 publications

References 38 publications

Accuracy of methods to measure femoral head penetration within metal-backed acetabular components

Accuracy of methods to measure femoral head penetration within metal-backed acetabular components

Validation of a computer‐assisted method for measurement of radiographic wear in total hip arthroplasty using all polyethylene cemented acetabular components

Validation of In Vivo Linear and Volumetric Wear Measurement for Reverse Total Shoulder Arthroplasty Using Model‐Based Radiostereometric Analysis

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