Park Sunghoon, Yun Jae Sung, Bang Dong-Ho, Jung Yongjun, Kwack Kyu-Sung, Kim Jung-Taek
Department of Radiology, Ajou University School of Medicine, Ajou Medical Center, Suwon 16499, Republic of Korea.
Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon 16499, Republic of Korea.
J Clin Med. 2023 Sep 26;12(19):6218. doi: 10.3390/jcm12196218.
This study aims to propose latitude cut deviation for differentiating hip arthroplasty types and evaluate its diagnostic utility in distinguishing total hip arthroplasty (THA) from hemiarthroplasty using radiography. After assessing various cup designs from top manufacturers for THA and hemiarthroplasty, we conducted a retrospective study on 40 patients (20 THA and 20 hemiarthroplasty). Three readers independently evaluated the radiographs, assessing acetabular sparing, cup-bone interface texture, and latitude cut deviation. Diagnostic performance and inter-observer agreement were compared using receiver operating characteristic curves and the Fleiss kappa coefficient. Latitude cut deviation measured on implant designs ranged from 19% to 42% in hemiarthroplasty and from -12% to 9% in THA. The sensitivity, specificity, and accuracy used to distinguish THA from hemiarthroplasty were 60-85%, 55-95%, and 62.5-77.5% for acetabular sparing; 100%, 50-80%, and 75-90% for cup-bone interface texture; and 100%, 90-100%, and 95-100% for latitude cut deviation. Inter-observer agreement for acetabular sparing, cup-bone interface texture, and latitude cut deviation ranged from moderate to excellent (κ = 0.499, 0.772, and 0.900, respectively). The latitude cut deviation exhibited excellent diagnostic performance and inter-reader agreement in distinguishing hemiarthroplasty from THA on radiographs, offering a concise way to identify hip arthroplasty type.
本研究旨在提出用于区分髋关节置换类型的髋臼截骨偏差，并通过X线摄影评估其在区分全髋关节置换术（THA）和半髋关节置换术方面的诊断效用。在评估了顶级制造商用于THA和半髋关节置换术的各种髋臼杯设计后，我们对40例患者（20例THA和20例半髋关节置换术）进行了一项回顾性研究。三位阅片者独立评估X线片，评估髋臼保留情况、髋臼杯-骨界面纹理和髋臼截骨偏差。使用受试者工作特征曲线和Fleiss卡方系数比较诊断性能和观察者间一致性。在植入物设计上测量的髋臼截骨偏差在半髋关节置换术中为19%至42%，在THA中为-12%至9%。用于区分THA和半髋关节置换术的髋臼保留情况的敏感性、特异性和准确性分别为60-85%、55-95%和62.5-77.5%；髋臼杯-骨界面纹理的分别为100%、50-80%和75-90%；髋臼截骨偏差的分别为100%、90-100%和95-100%。观察者间在髋臼保留情况、髋臼杯-骨界面纹理和髋臼截骨偏差方面的一致性从中度到优（κ分别为0.499、0.772和0.900）。髋臼截骨偏差在通过X线片区分半髋关节置换术和THA方面表现出优异的诊断性能和阅片者间一致性，为识别髋关节置换类型提供了一种简洁的方法。
