Abstract
The most common method to diagnose and monitor osteolysis is the standard anteroposterior radiograph. Unfortunately, plain radiographs underestimate the incidence and extent of osteolysis. CT scans are more sensitive and accurate but also more expensive and subject patients to more radiation. To determine whether the volume of pelvic osteolysis could be accurately estimated without a CT scan, we evaluated the relationships between CT volume measurements and other variables that may be related to the size of pelvic osteolytic lesions in 78 THAs. Only the area of pelvic osteolysis measured on radiographs, heavy patient activity level, and total volume of wear were associated with the pelvic osteolysis volume measured on CT in the context of the multivariate regression analysis. Despite a strong correlation (r = 0.93, r2 = 0.87) between these three variables and the volume of pelvic osteolysis measured on CT, estimates of pelvic osteolysis volume deviated from the actual volume measured on CT by more than 10 cm3 among eight of the 78 THAs in this study. CT images remain our preferred modality when accurate assessments of pelvic osteolysis volume are required.
Level of Evidence: Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
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The Anderson Orthopaedic Research Institute has received funding from Inova Health System and from a cooperative agreement awarded and administered by the US Army Medical Research & Materiel Command (USAMRMC) and the Telemedicine & Advanced Technology Research Center (TATRC) to support this study. Two of the authors (CAE and CAE, Jr.) receive royalties from DePuy, a Johnson & Johnson company. One author (CAE, Jr.) serves as a consultant for DePuy and another author (CAE) owns Johnson & Johnson stock.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
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Egawa, H., Powers, C.C., Beykirch, S.E. et al. Can the Volume of Pelvic Osteolysis be Calculated without Using Computed Tomography?. Clin Orthop Relat Res 467, 181–187 (2009). https://doi.org/10.1007/s11999-008-0522-y
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DOI: https://doi.org/10.1007/s11999-008-0522-y