Radiolucent lines and component stability in knee arthroplasty. Standard versus fluoroscopically-assisted radiographs.
Radiolucent lines and component stability in knee arthroplasty. Standard versus fluoroscopically-assisted radiographs.
复制标题
膝关节置换术中的射线可透线和组件稳定性。
DOI：
10.1302/0301-620x.81b1.0810024
复制
发表时间：
1999
影响因子：
--
通讯作者：
P. Bamert
中科院分区：
文献类型：
--
作者：
P. Vyskočil;C. Gerber;P. Bamert
6 名骨科医生根据当天拍摄的常规前后位和侧位 X 光片以及荧光透视图对 66 例膝关节置换术组件的射线可透线和稳定性进行了评估。检查者对患者和临床结果不知情。五个月后重复对射线照片的解读。在荧光镜辅助射线照片上，六名检查者中的四名发现股骨组件的射线可透线明显增多（p < 0.05），而胫骨植入物的射线可透线则明显增多。五名检查员在荧光镜辅助放射照片上将更多的股骨组件评为放射学松动（p = 0.0008 至 0.0154），但没有人对胫骨组件进行如此评价。对于这两种成分，荧光镜辅助放射线照片的观察者内和观察者间的平均 kappa 值较高。我们已经证明，荧光镜辅助射线照片可以更重复地检测全膝关节置换术中的射线可透线，因此更可靠。成分稳定性的评估很大程度上受到所使用的放射技术的影响。传统的X线照片不足以评估全膝关节置换术的稳定性，应由透视辅助胶片取代。
The radiolucent lines and the stability of the components of 66 knee arthroplasties were assessed by six orthopaedic surgeons on conventional anteroposterior and lateral radiographs and on fluoroscopic views which had been taken on the same day. The examiners were blinded as to the patients and clinical results. The interpretation of the radiographs was repeated after five months. On fluoroscopically-assisted radiographs four of the six examiners identified significantly more radiolucent lines for the femoral component (p < 0.05) and one significantly more for the tibial implant. Five examiners rated more femoral components as radiologically loose on fluoroscopically-assisted radiographs (p = 0.0008 to 0.0154), but none did so for the tibial components. The mean intra- and interobserver kappa values were higher for fluoroscopically-assisted radiographs for both components. We have shown that fluoroscopically-assisted radiographs allow more reproducible, and therefore reliable, detection of radiolucent lines in total knee arthroplasty. Assessment of the stability of the components is significantly influenced by the radiological technique used. Conventional radiographs are not adequate for evaluation of the stability of total knee arthroplasty and should be replaced by fluoroscopically-assisted films.