Analysis of Polyethylene Wear in Plain Radiographs

Overview

Journal Acta Orthop

Specialty Orthopedics

Date 2009 Dec 10

PMID 19995318

Citations 2

Authors

Maiken Stilling

Kjeld Soballe

Niels Trolle Andersen

Kristian Larsen

Ole Rahbek

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Two-dimensional computerized radiographic techniques are frequently used to measure in vivo polyethylene (PE) wear after total hip arthroplasty (THA), and several variables in the clinical set-up may influence the amount of wear that is measured. We compared the repeatability and concurrent validity of linear PE wear on plain radiographs using the same software but a different number of radiographs.

Methods: We used either 1, 2, or 6 anteroposterior (AP) hip radiographs of 11 patients from a clinical THA series with 12 years of follow-up, and measured the PE wear with the software PolyWare 3D Pro. Repeatability within and concurrent validity between the different numbers of radiograph strategies were assessed using limits of agreement (LOAs) and bias.

Results: Observed median wear (range) in mm was 3.4 (1.6-4.6), 2.3 (0.7-4.9), and 4.0 (2.6-6.2) for the 1-, 2-, and 6-radiograph strategies. For repeatability, no bias (p > 0.41) was observed. LOAs around the bias were + or - 0.6, + or - 0.4, and + or - 1.2 mm for the 1-, 2-, and 6-radiograph strategies. For concurrent validity, a bias (+ or - LOA) between all pairwise comparisons was observed (p < 0.02) with 0.8 mm (+ or - 2.5) between the 1- and 2-radiograph strategies, 1.0 mm (+ or - 2.2) between the 1- and 6-radiograph strategies, and 1.8 mm (+ or - 1.2) between the 2- and 6-radiograph strategies.

Interpretation: The number of radiographs used for wear measurement with a shadow-casting analysis method on plain AP radiographs influences the amount of linear wear measured. Results of PE wear obtained with PolyWare in studies using a different number of radiographs are not comparable.

Citing Articles

Dimensional analysis of total hip arthroplasty polyethylenes.

Schwartsmann C, de Freitas Spinelli L, Boschin L, Goncalves R, Yepez A, Strohaecker T Rev Bras Ortop. 2019; 48(6):500-504.

PMID: 31304160 PMC: 6565973. DOI: 10.1016/j.rboe.2013.12.006.

The final follow-up plain radiograph is sufficient for clinical evaluation of polyethylene wear in total hip arthroplasty. A study of validity and reliability.

Stilling M, Larsen K, Andersen N, Soballe K, Kold S, Rahbek O Acta Orthop. 2010; 81(5):570-8.

PMID: 20860443 PMC: 3214745. DOI: 10.3109/17453674.2010.506632.

References

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

The B, Flivik G, Diercks R, Verdonschot N . A new method to make 2-D wear measurements less sensitive to projection differences of cemented THAs. Clin Orthop Relat Res. 2008; 466(3):684-90. PMC: 2505227. DOI: 10.1007/s11999-007-0077-3. View

Stilling M, Rahbek O, Soballe K . Inferior survival of hydroxyapatite versus titanium-coated cups at 15 years. Clin Orthop Relat Res. 2009; 467(11):2872-9. PMC: 2758968. DOI: 10.1007/s11999-009-0796-8. View

Borlin N, Rohrl S, Bragdon C . RSA wear measurements with or without markers in total hip arthroplasty. J Biomech. 2005; 39(9):1641-50. DOI: 10.1016/j.jbiomech.2005.05.004. View

Bragdon C, Thanner J, Greene M, Malchau H, Digas G, Harris W . Standing versus supine radiographs in RSA evaluation of femoral head penetration. Clin Orthop Relat Res. 2006; 448:46-51. DOI: 10.1097/01.blo.0000224012.50292.67. View

Ebramzadeh E, Sangiorgio S, Lattuada F, Kang J, Chiesa R, McKellop H . Accuracy of measurement of polyethylene wear with use of radiographs of total hip replacements. J Bone Joint Surg Am. 2003; 85(12):2378-84. DOI: 10.2106/00004623-200312000-00016. View

Hui A, McCalden R, Martell J, MacDonald S, Bourne R, Rorabeck C . Validation of two and three-dimensional radiographic techniques for measuring polyethylene wear after total hip arthroplasty. J Bone Joint Surg Am. 2003; 85(3):505-11. DOI: 10.2106/00004623-200303000-00017. View

Sychterz C, Young A, Engh C . Effect of radiographic quality on computer-assisted head penetration measurements. Clin Orthop Relat Res. 2001; (386):150-8. DOI: 10.1097/00003086-200105000-00019. View

Norton M, Yarlagadda R, Anderson G . Catastrophic failure of the Elite Plus total hip replacement, with a Hylamer acetabulum and Zirconia ceramic femoral head. J Bone Joint Surg Br. 2002; 84(5):631-5. DOI: 10.1302/0301-620x.84b5.12679. View

10.

Sochart D . Relationship of acetabular wear to osteolysis and loosening in total hip arthroplasty. Clin Orthop Relat Res. 1999; (363):135-50. View

11.

Dowd J, Sychterz C, Young A, Engh C . Characterization of long-term femoral-head-penetration rates. Association with and prediction of osteolysis. J Bone Joint Surg Am. 2000; 82(8):1102-7. DOI: 10.2106/00004623-200008000-00006. View

12.

Orishimo K, Sychterz C, Hopper Jr R, Engh C . Can component and patient factors account for the variance in wear rates among bilateral total hip arthroplasty patients?. J Arthroplasty. 2003; 18(2):154-60. DOI: 10.1054/arth.2003.50023. View

13.

Geerdink C, Grimm B, Vencken W, Heyligers I, Tonino A . The determination of linear and angular penetration of the femoral head into the acetabular component as an assessment of wear in total hip replacement: a comparison of four computer-assisted methods. J Bone Joint Surg Br. 2008; 90(7):839-46. DOI: 10.1302/0301-620X.90B7.20305. View

14.

von Schewelov T, Onsten I, Markusson P, Carlsson A . Weight bearing radiographs are not necessary for measurement of polyethylene penetration in total hip prostheses: a radiostereometric study of 111 patients examined in weight-bearing and supine position. Acta Orthop. 2006; 77(1):104-8. DOI: 10.1080/17453670610045768. View

15.

Devane P, Bourne R, Rorabeck C, MacDonald S, Robinson E . Measurement of polyethylene wear in metal-backed acetabular cups. II. Clinical application. Clin Orthop Relat Res. 1995; (319):317-26. View

16.

Glyn-Jones S, McLardy-Smith P, Gill H, Murray D . The creep and wear of highly cross-linked polyethylene: a three-year randomised, controlled trial using radiostereometric analysis. J Bone Joint Surg Br. 2008; 90(5):556-61. DOI: 10.1302/0301-620X.90B5.20545. View

17.

Livermore J, Ilstrup D, Morrey B . Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg Am. 1990; 72(4):518-28. View

18.

Soballe K, Toksvig-Larsen S, Gelineck J, Fruensgaard S, Hansen E, Ryd L . Migration of hydroxyapatite coated femoral prostheses. A Roentgen Stereophotogrammetric study. J Bone Joint Surg Br. 1993; 75(5):681-7. DOI: 10.1302/0301-620X.75B5.8397213. View

19.

McCalden R, Naudie D, Yuan X, Bourne R . Radiographic methods for the assessment of polyethylene wear after total hip arthroplasty. J Bone Joint Surg Am. 2005; 87(10):2323-34. DOI: 10.2106/JBJS.E.00223. View

20.

Bragdon C, Malchau H, Yuan X, Perinchief R, Karrholm J, Borlin N . Experimental assessment of precision and accuracy of radiostereometric analysis for the determination of polyethylene wear in a total hip replacement model. J Orthop Res. 2002; 20(4):688-95. DOI: 10.1016/S0736-0266(01)00171-1. View