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

Abstract

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.