Assessing wear of the acetabular cup using computed tomography: an ex vivo study.
OBJECTIVE
To validate a clinically useful method for measuring acetabular cup wear using computed tomography (CT).


METHODS
Eight uncemented acetabular cups were scanned twice ex vivo using CT. The linear penetration depth of the femoral component head into the cup and the thickness of the remaining polyethylene liner were measured in the CT volumes using dedicated software. Two independent examiners twice assessed each volume. The CT measurements were compared to direct measurements using a coordinate measuring device and micrometer measurements.


RESULTS
Accuracy of wear measurements expressed as penetration depth was +/-0.6 and +/- 1.0 mm for the two examiners, respectively, with no significant differences between examiners, trials, and CT scans. Accuracy of measurements of remaining polyethylene was +/- 1.3 and +/- 1.0 mm, respectively, for the two examiners. Systematic differences between examiners were found, but no significant differences between trials and CT scans. These differences were due to different interpretations of metal artifacts in the volumes.


CONCLUSIONS
The proposed CT method for evaluating wear as head penetration depth allows for reliable wear detection at a clinically relevant level. Measurements of remaining polyethylene on CT volumes are not as reliable as wear measurements owing to metal artifacts.
Olivecrona
L
L
Department of Radiology, Karolinska University Hospital Solna, Stockholm, Sweden. charlotta.olivecrona@karolinska.se
Jedenmalm
A
A
Aspelin
P
P
Weidenhielm
L
L
Noz
M E
ME
Maguire
G Q
GQ
Zeleznik
M P
MP
Olivecrona
H
H
D020878:Device Removal; D019544:Equipment Failure Analysis / Q000379:methods*; D005240:Feasibility Studies; D006622:Hip Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D020959:Polyethylene; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
D020959:Polyethylene