title: Computed tomography vs. digital radiography assessment for detection of osteolysis in asymptomatic patients with uncemented cups: a proposal for a new classification system based on computer tomography.
abstract: Digital radiographic images in the anterior-posterior and lateral view have been gold standard for evaluation of peri-acetabular osteolysis for patients with an uncemented hip replacement. We compared digital radiographic images and computer tomography in detection of peri-acetabular osteolysis and devised a classification system based on computer tomography. Digital radiographs were compared with computer tomography on 206 hips, with a mean follow up 10 years after surgery. The patients had no clinical signs of osteolysis and none were planned for revision surgery. On digital radiographs, 192 cases had no osteolysis and only 14 cases had osteolysis. When using computer tomography there were 184 cases showing small or large osteolysis and only 22 patients had no osteolysis. A classification system for peri-acetabular osteolysis is proposed based on computer tomography that is easy to use on standard follow up evaluation.
authors.affiliation: Division of Orthopaedics, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Buster
authors.initials: B
authors.lastname: Sandgren
authors.forename: Joakim
authors.initials: J
authors.lastname: Crafoord
authors.forename: Göran
authors.initials: G
authors.lastname: Garellick
authors.forename: Lars
authors.initials: L
authors.lastname: Carlsson
authors.forename: Lars
authors.initials: L
authors.lastname: Weidenhielm
authors.forename: Henrik
authors.initials: H
authors.lastname: Olivecrona
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010014:Osteolysis / Q000145:classification* / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D001843:Bone Cements
keywords: CT based classification system; Computed Tomography (CT); Digital Radiographs (DR); Peri-Acetabular Osteolysis (PAO); metal cups