Cimen Osman, Kaygusuz Mehmet Akif
Department of Orthopedics and Traumatology, Ministry of Health Metin Sabanci Baltalimani Bone and Joint Diseases Training and Research Hospital, Hisar Street, No: 56, 34470, Sarıyer, İstanbul, Turkey.
J Orthop. 2022 Aug 27;34:152-159. doi: 10.1016/j.jor.2022.08.022. eCollection 2022 Nov-Dec.
Lack of consensus on which measurement method gives the most accurate results for medullary canal filling ratio (CFR) of stems used in revision knee prostheses causes confusion when interpreting scientific studies. Therefore, the present study aims to find the most accurate measurement method of CFR on direct radiographs.
Twenty-eight femoral and 27 tibial components of 29 patients with a mean age of 72.86 ± 6.32 years were included in the study. Two different methods were used for computerized tomography CFR measurement. These methods and five different radiographic measurement methods used for CFR were compared statistically.
There was no statistically significant difference between the real tomographic CFR of the femoral stem and the CFR calculation made by using ellipse area (p > 0.05). There was also no statistically significant difference between the tomographic CFR measurement calculated according to the largest stem size that can be implanted, and the method that accepted the smallest value as CFR after the measurement made according to Parsley's method on AP and lateral radiographs (p > 0.05). The results obtained by using all other tests were statistically different from each other.
CFR calculation made by using ellipse area, is the most accurate method for femoral stem CFR. The method that accepted the smallest value as CFR after the measurement made according to Parsley's method on AP and lateral radiographs is the most accurate method for tibial stem CFR.
对于翻修膝关节假体中使用的股骨柄髓腔填充率(CFR),哪种测量方法能给出最准确的结果尚无共识,这在解释科学研究时会造成困惑。因此,本研究旨在找到直接X线片上CFR的最准确测量方法。
本研究纳入了29例平均年龄为72.86±6.32岁患者的28个股骨组件和27个胫骨组件。采用两种不同方法进行计算机断层扫描CFR测量。对这些方法与用于CFR的五种不同的X线测量方法进行统计学比较。
股骨柄的实际断层扫描CFR与使用椭圆面积计算的CFR之间无统计学显著差异(p>0.05)。根据可植入的最大柄尺寸计算的断层扫描CFR测量值与在前后位和侧位X线片上根据Parsley方法测量后将最小值作为CFR的方法之间也无统计学显著差异(p>0.05)。使用所有其他测试获得的结果彼此之间存在统计学差异。
使用椭圆面积计算CFR,是股骨柄CFR最准确的方法。在前后位和侧位X线片上根据Parsley方法测量后将最小值作为CFR的方法,是胫骨柄CFR最准确的方法。