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Boettner F, Sculco PK, Lipman J, Saboeiro G, Renner L, Faschingbauer M. The effect of a low radiation CT protocol on accuracy of CT guided implant migration measurement: A cadaver study. J Orthop Res 2016; 34:725-8. [PMID: 26425921 DOI: 10.1002/jor.23060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/25/2015] [Indexed: 02/04/2023]
Abstract
The current study compared the impact of low radiation CT protocols on the accuracy, repeatability, and inter- and intra-observer variability of implant migration studies in total hip arthroplasty. Two total hip replacements were performed in two human cadavers and six tantalum beads were inserted into the femur similar to radiostereometric analysis. Six different 28 mm heads (-3 mm, 0 mm, 2.5 mm, 5.0 mm, 7.5 mm, and 10 mm) were added to simulate five reproducible translations (maximum total point migration) of the center of the head. Three CT scans with varying levels of radiation were performed for each head position. The effective dose (mSv) was 3.8 mSv for Protocol A (standard protocol), 0.7 mSv for Protocol B and 1.6 mSv for Protocol C. Implant migration was measured in a 3-D analysis software (Geomagic Studio 7). The accuracy was 0.16 mm for CT Protocol A, 0.13 mm for Protocol B and 0.14 mm for Protocol C; The repeatability was 0.22 mm for CT Protocol A, 0.18 mm for Protocol B and 0.20 mm for Protocol C; ICC for inter observer reliability was 0.89, intra observer reliability was 0.95. The difference in accuracy between standard protocol A and the two low radiation protocols (B, C) was less than 0.05 mm. The accuracy, inter- and intra-observer reliability of all three CT protocols is comparable to radiostereometric analysis. Reducing the CT radiation exposure to numbers similar to an AP Pelvis radiograph (0.7 mSv protocol B) does not affect the accuracy of implant migration measurements.
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Affiliation(s)
- Friedrich Boettner
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021
| | - Peter K Sculco
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021
| | - Joseph Lipman
- Department of Biomechanics, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021
| | - Gregory Saboeiro
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021
| | - Lisa Renner
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021
| | - Martin Faschingbauer
- Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York City, New York, 10021.,Department of Orthopedic Surgery, University Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
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