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J Arthroplasty. 2008 Sep;23(6):833-8. doi: 10.1016/j.arth.2007.07.017. Epub 2008 Mar 7.

Computer-assisted technique to delineate osteolytic lesions around the femoral component in total hip arthroplasty.

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  • 1Department of Radiology, University of California, San Francisco, California 94107, USA.


There are currently no ideal quantitative measures assessing osteolysis after total joint arthroplasty. This study reports a new approach for quantification of osteolytic lesions on radiographs of total hip arthroplasty with the hypothesis that computer-assisted lesion quantification improves analysis precision over currently used qualitative visual assessment and thus improves progression monitoring. Duplicate exposure sets of anterior-posterior and frog-leg view radiographs of 15 volunteer total hip arthroplasty patients with radiographically evident periprosthetic lucencies were used. Two independent readers delineated the lesions using on-screen digital marker tools. Based on duplicate readings of the first exposure set only, intraoperator precision had a coefficient of variation (CV) from 1.5% to 3.4%, whereas interoperator precision CV ranged from 3.2% to 4.6%. The reproducibility of the x-ray technique as assessed by single readings of both sets of x-rays was CV 3.2% to 4.8%. The new technique compares favorably to precision of qualitative visual assessment and permits more accurate detection and quantitation of osteolytic lesions.

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