Accuracy of measurement of polyethylene wear with use of radiographs of total hip replacements
Accuracy of measurement of polyethylene wear with use of radiographs of total hip replacements
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DOI：
10.2106/00004623-200312000-00016
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发表时间：
2003-12-01
影响因子：
5.3
通讯作者：
Dorr, LD
中科院分区：
文献类型：
--
作者：
Ebramzadeh, E;Sangiorgio, SN;Dorr, LD
背景：虽然从全髋关节置换术的X线片中估计聚乙烯衬垫磨损的方法有很多，但对于这些方法的准确性还没有达成共识。本研究的目的是利用实验室X线片和常规临床X线片，比较几种测量方法的准确性。方法：设计一种体模装置，模拟不同程度的杯外展和前倾角的三维磨损随机值，并获得每个值的正位和横位侧位片。使用Charnley双放射摄影法、利弗莫尔法和Dorr和wan描述的方法，以及使用PolyWare和Hip32软件包，在有和没有三维测量的情况下测量磨损。14例患者在翻修手术前根据常规X线片测量临床磨损量，并与使用三坐标测量机直接从取出的衬垫测量的磨损量进行比较。结果：对于实验室X线片，livermore法和两种计算机化方法的中位误差分别为0.1 mm、0.23 mm和1.7 mm。最大误差在0.6毫米(利弗莫尔)到4.3毫米(多尔和万)之间。相比之下，使用临床X线片，中位误差在0.2 mm(Hip32)到0.6 mm(Dorr和wan)之间。最大误差在1.8 mm(Dorr和wan)到2.5 mm(Livermore)之间。结论和临床相关性：对于实验室X线片，计算机化的聚乙烯磨损测量方法比人工方法提供了明显更高的准确性；然而，对于临床X线片，它们只提供了略高的准确性。尽管在研究环境中，提高计算机化方法的准确性可能是必要的，但手动方法为常规的临床磨损评估提供了足够的准确性。
Background: Although a number of methods are used to estimate polyethylene liner wear from radiographs of total hip replacements, there is no consensus with regard to the accuracy of these methods. The purpose of this study was to compare the accuracy of several such measurement methods with use of both laboratory radiographs and routine clinical radiographs.Methods: A phantom apparatus was designed to simulate random values of three-dimensional wear, with varying degrees of cup abduction and anteversion, and to obtain anteroposterior and cross-table lateral radiographs with each value. Wear was measured with use of the Charnley duoradiographic method, the Livermore method, and the method described by Dorr and Wan, as well as with use of PolyWare and Hip32 software packages, both with and without three-dimensional measurements. Clinical wear was measured from conventional radiographs made prior to revision surgery in fourteen patients and was compared with wear measured directly from the retrieved liners with use of a coordinate measuring machine.Results: With laboratory radiographs, median errors were 0.1 mm with the Livermore method and both computerized methods, 0.23 mm with the Charnley method, and 1.7 mm with the method of Dorr and Wan. Maximum errors were between 0.6 mm (Livermore) and 4.3 mm (Dorr and Wan). In contrast, with use of clinical radiographs, median errors ranged between 0.2 mm (Hip32) and 0.6 mm (Dorr and Wan). Maximum errors ranged between 1.8 mm (Dorr and Wan) and 2.5 mm (Livermore).Conclusions and Clinical Relevance: With laboratory radiographs, computerized methods of polyethylene wear measurement offered distinctly greater accuracy than did manual methods; however, with clinical radiographs, they offered only slightly better accuracy. Although the increased accuracy of computerized methods may be necessary in research settings, manual methods provided sufficient accuracy for routine clinical assessment of wear.