Radiographic signs of osseointegration in porous-coated acetabular components
Radiographic signs of osseointegration in porous-coated acetabular components
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DOI：
10.1097/01.blo.0000201149.14078.50
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发表时间：
2006-03-01
影响因子：
4.2
通讯作者：
Engh, Charles A., Sr.
中科院分区：
文献类型：
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作者：
Moore, Milan S.;McAuley, James P.;Engh, Charles A., Sr.
目前还没有直接的方法可以通过射线照相确定未骨水泥、多孔涂层髋臼假体的骨整合。我们定义了五种放射学标志来检测髋臼骨整合：（1）缺乏射线可透线； (2) 存在上外侧支撑； (3)内侧应力屏蔽； (4) 放射状小梁； (5)内侧下支撑。我们通过查看一系列 119 例进行翻修手术的全髋关节置换术的初次术后和翻修前的 X 光片，评估了他们预测髋臼骨整合的能力。每个体征对于骨向内生长的存在具有较高的阳性预测值（范围，92.2-96.3%）。射线可透线的缺失、上外侧支撑的存在以及内侧应力屏蔽的存在是指示骨向内生长的最敏感的迹象。 97% 具有 3 到 5 种迹象的杯子是向骨内生长的，而 83% 具有 1 种或没有迹象的杯子是不稳定的。当存在三种或更多体征时，放射学检查的阳性预测值为96.9%，敏感性为89.6%，特异性为76.9%。髋臼骨整合的五个迹象可以可靠地预测骨整合，尤其是组合使用时。它们可用作放射学评估多孔涂层非骨水泥杯患者状态的工具。
There currently is no direct method to radiographically determine osseointegration of an uncemented, porous-coated acetabular component. We defined five radiographic signs for detecting acetabular osseointegration: (1) absence of radiolucent lines; (2) presence of a superolateral buttress; (3) medial stress-shielding; (4) radial trabeculae; and (5) an inferomedial buttress. We assessed their ability to predict acetabular osseointegration by reviewing the postprimary and prerevision radiographs from a series of 119 total hip arthroplasties that had revision surgery. Each sign had a high positive predictive value for the presence of bone ingrowth (range, 92.2-96.3%). The absence of radiolucent lines, presence of superolateral buttresses, and presence of medial stress-shielding were the most sensitive signs for indicating bone ingrowth. Ninety-seven percent of the cups with three to five signs were bone ingrown, whereas 83% of the cups with one or no signs were unstable. When three or more signs were present, the positive predictive value of the radiographic test was 96.9%, the sensitivity was 89.6%, and the specificity was 76.9%. The five signs of acetabular osseointegration reliably predicted osseointegration, especially when used in combination. They can be used as a tool for radiographically assessing the status of patients with porous-coated uncemented cups.