Radiographic Signs of Osseointegration in Porous-coated Acetabular Components
| Autor: | Charles A. Engh, Anthony M. Young, Milan S Moore, James P. McAuley |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Reoperation
medicine.medical_specialty Time Factors Arthroplasty Replacement Hip Radiodensity medicine.medical_treatment Radiography Dentistry Prosthesis Design Osseointegration Predictive Value of Tests Humans Medicine Orthopedics and Sports Medicine Bony Callus business.industry Acetabulum General Medicine Arthroplasty Treatment Outcome Predictive value of tests Orthopedic surgery Surgery Hip Prosthesis Level iii business Porosity Follow-Up Studies |
| Zdroj: | Clinical Orthopaedics & Related Research. 444:176-183 |
| ISSN: | 0009-921X |
| Popis: | UNLABELLED 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 radio-graphic 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 radio-graphically assessing the status of patients with porous-coated uncemented cups. LEVEL OF EVIDENCE Diagnostic study, Level III (Study of nonconsecutive patients; without consistently applied reference "gold" standard). See the Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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