Department of Orthopaedics, University Hospital Heidelberg, Schlierbacher Landstrasse 200a, Heidelberg, 69118, Germany.
Institute for Clinical Anatomy and Cell Analysis, University of Tübingen, Elfriede-Aulhorn-Straße 8, Tübingen, 72076, Germany.
Arch Orthop Trauma Surg. 2024 Sep;144(9):4499-4504. doi: 10.1007/s00402-024-05556-3. Epub 2024 Sep 24.
The radiographic evaluation of novel cementless anatomic polyethylene (PE) glenoid components featuring a titanium-coated back is still unclear. This study explores potential radiolucent lines (RLL) between the radiopaque titanium layer and sclerotic convex reamed bone in an intermodal comparison analysis with computed tomography (CT) scans.
Eight RM pressfit vitamys glenoids (Mathys) were implanted into cadaveric scapulae. In the CT scans, glenoids were quantified by evaluating ideal complete bony support (NO GAP) and gap between bone and titanium coating (GAP). X-rays were in perfect 0-degree projection and tilted in ± 10° and ± 20° mediolateral (ml) and craniocaudal (cc) directions. Radiographs evaluated were graded as NO RLL, RLL (gap > 1 mm) or DL (double line, gap < 1 mm) in an intermodal comparison of CT and X-ray findings.
The inter-rater (Cohen's = 0.643) and intra-rater reliability (Cohen's = 0.714) were good. The overall evaluation showed a significant agreement between (NO) RLL on X-ray and (NO) GAP on CT (p < 0.001). The - 10-degree ml projection showed good agreement between CT and X-ray (Cohen's = 0.628). Adequate agreement was shown at 0 degrees (Cohen's = 0.386), + 10 degrees ml (Cohen's = 0.338), and + 20 degrees cc (Cohen's = 0.327). Compared to the scenario DL = NO RLL, the true a.p. view showed better sensitivity when the DL is classified as RLL. Conversely, the true a.p. view demonstrated both better specificity and significant agreement between the X-ray and CT findings in scenario when DL = No RLL.
Standard true a. p. projections are reliable in ruling out gaps when no RLL or DL is visible and the detection of RLL shows high intermodal agreement. Varying agreement across tilting angles emphasizes the importance of a comprehensive approach in evaluating bone support and CT is indispensable for a scientifically reliable assessment.
Level III Treatment Study.
新型无水泥解剖型聚乙烯（PE）关节盂假体的放射学评估仍不明确，该研究通过 CT 扫描的模态间比较分析，探讨了不透射线钛涂层与硬化凸面磨锉骨之间潜在的透光线（RLL）。
8 个 RM pressfit vitamys 关节盂假体（Mathys）植入尸体肩胛骨。在 CT 扫描中，通过评估理想的完全骨性支撑（无间隙，NO GAP）和骨与钛涂层之间的间隙（间隙，GAP）对关节盂进行定量评估。X 射线以完美的 0 度投影，并在 ±10°和 ±20°的内外侧（ml）和头尾（cc）方向倾斜。X 射线评估为模态间 CT 和 X 射线结果的比较分为无 RLL、RLL（间隙>1mm）或 DL（双线，间隙<1mm）。
观察者间（Cohen's=0.643）和观察者内（Cohen's=0.714）可靠性良好。总体评估显示，X 射线上的 RLL（无）与 CT 上的 GAP（无）之间具有显著一致性（p<0.001）。-10°ml 投影显示 CT 与 X 射线之间具有良好的一致性（Cohen's=0.628）。在 0°（Cohen's=0.386）、+10°ml（Cohen's=0.338）和+20°cc（Cohen's=0.327）时，结果适度一致。与 DL=RLL 相比，在 DL 分类为 RLL 时，真实的前后位视图具有更好的敏感性。相反，在 DL=无 RLL 时，真实的前后位视图在 X 射线和 CT 结果之间显示出更好的特异性和显著一致性。
标准的真实前后位投影在无 RLL 或 DL 时可可靠排除间隙，当 RLL 可见时，检测 RLL 具有较高的模态间一致性。各倾斜角度之间的一致性差异强调了全面评估骨支撑的重要性，CT 对于科学可靠的评估是不可或缺的。
三级治疗研究。
