Comparison of Marker-Based RSA and CT-RSA for Analyzing Micromotions After Distal Radius Osteotomy: A 1-Year Retrospective Study of 24 Patients.

Abstract

Radiostereometric Analysis (RSA) is the most accurate method for determining early micromotions of orthopedic implants. Computed Tomography Radiostereometric Analysis (CT-RSA) is a method that can be used to determine implant and bone micromovements using low-dose CT scans. This study aimed to evaluate the reliability of the CT-RSA method in measuring the interfragmental mobility in patients who have undergone a correction osteotomy due to a malunited distal radius fracture. Twenty-four patients were included and operated with a radiolucent volar plate. Markers were embedded in the plate and bone. RSA and CT examinations were obtained postoperatively up to 1-year postoperative. Micromovements of the distal radius segment relative to the proximal were compared between the methods with paired analysis and Bland-Altman plots. The limits of clinical significance were: dorsal/volar tilt < 10°, radial shortening < 5 mm, radial inclination ≥ 15°, and radial shift < 5 mm. For the dorsal/volar tilt, the paired analysis between the two methods, showed a mean difference (95% CI) of -0.06° (-0.67 to 0.55), for radial compression-0.04 mm (-0.09 to 0.01), for radial inclination 0.21° (-0.06 to 0.48), and for radial shift -0.07 mm (-0.21 to 0.07). The paired analysis for micromotions showed that the thresholds of clinical significance are excluded from the difference's 95% CI. The Bland-Altman plots showed comparable results up to 1 year, considering clinically relevant thresholds. In conclusion, the CT-RSA method is comparable to that of marker-based RSA in measuring micromotions after wrist osteotomy, as the differences between the methods are not clinically significant.