Department of Orthopedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund.
Ortoma AB, Gothenburg, Sweden.
Acta Orthop. 2024 Jan 29;95:39-46. doi: 10.2340/17453674.2024.35749.
Radiostereometry (RSA) is the current gold standard for evaluating early implant migration. CT-based migration analysis is a promising method, with fewer handling requirements compared with RSA and no need for implanted bone-markers. We aimed to evaluate agreement between a new artificial intelligence (AI)-based CT-RSA and model-based RSA (MBRSA) in measuring migration of cup and stem in total hip arthroplasty (THA).
30 patients with THA for primary osteoarthritis (OA) were included. RSA examinations were performed on the first postoperative day, and at 2 weeks, 3 months, 1, 2, and 5 years after surgery. A low-dose CT scan was done at 2 weeks and 5 years. The agreement between the migration results obtained from MBRSA and AI-based CT-RSA was assessed using Bland-Altman plots.
Stem migration (y-translation) between 2 weeks and 5 years, for the primary outcome measure, was -0.18 (95% confidence interval [CI] -0.31 to -0.05) mm with MBRSA and -0.36 (CI -0.53 to -0.19) mm with AI-based CT-RSA. Corresponding proximal migration of the cup (y-translation) was 0.06 (CI 0.02-0.09) mm and 0.02 (CI -0.01 to 0.05) mm, respectively. The mean difference for all stem and cup comparisons was within the range of MBRSA precision. The AI-based CT-RSA showed no intra- or interobserver variability.
We found good agreement between the AI-based CT-RSA and MBRSA in measuring postoperative implant migration. AI-based CT-RSA ensures user independence and delivers consistent results.
放射立体测量术（RSA）是评估早期植入物迁移的金标准。基于 CT 的迁移分析是一种很有前途的方法，与 RSA 相比，它的处理要求更少，并且不需要植入骨标记物。我们旨在评估一种新的基于人工智能（AI）的 CT-RSA 与基于模型的 RSA（MBRSA）在测量全髋关节置换术（THA）中杯和柄的迁移方面的一致性。
纳入 30 例因原发性骨关节炎（OA）接受 THA 的患者。术后第 1 天、第 2 周、第 3 个月、第 1 年、第 2 年和第 5 年进行 RSA 检查。术后第 2 周和第 5 年进行低剂量 CT 扫描。使用 Bland-Altman 图评估 MBRSA 和基于 AI 的 CT-RSA 获得的迁移结果之间的一致性。
对于主要结局指标，在 2 周和 5 年之间，柄的迁移（y 平移）分别为 MBRSA 下的-0.18（95%置信区间[CI]：-0.31 至-0.05）mm 和基于 AI 的 CT-RSA 下的-0.36（CI：-0.53 至-0.19）mm。相应的杯近端迁移（y 平移）分别为 0.06（CI：0.02-0.09）mm 和 0.02（CI：-0.01 至 0.05）mm。所有柄和杯比较的平均差值均在 MBRSA 精度范围内。基于 AI 的 CT-RSA 显示出没有观察者内或观察者间的变异性。
我们发现基于 AI 的 CT-RSA 与 MBRSA 在测量术后植入物迁移方面具有良好的一致性。基于 AI 的 CT-RSA 确保了用户的独立性并提供了一致的结果。
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