de Laat Nienke N, Koster Lennard A, Stoel Berend C, Nelissen Rob G H H, Kaptein Bart L
Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
J Orthop Res. 2025 Feb;43(2):311-321. doi: 10.1002/jor.25989. Epub 2024 Oct 15.
Radiostereometric analysis (RSA) is the current gold standard to determine implant migration, but it requires bone markers and special equipment. Therefore, we developed VoluMetric Matching Micromotion Analysis (V3MA), a software program for Computed Tomography-based radiostereometric analysis (CT-RSA). This study aimed to determine the accuracy and precision of V3MA in vitro compared to RSA and provide a clinical proof of concept. The accuracy (RMSE (Root Mean Squared Error)) and precision (SD (standard deviation)) of V3MA were compared to RSA. A tibial component was placed in 21 different positions within a cadaveric bone to assess accuracy. For precision, a total of 20 repeated zero-migration examinations from 4 cadaveric bones with cemented tibial components were performed. In 6 total knee arthroplasty (TKA) patients 1 to 5 year migration was measured with V3MA and RSA. V3MA accuracy ranged between 0.02 and 0.09 mm for translations and was 0.01° for internal-external rotations. For RSA, the accuracy ranged between 0.03 and 0.09 mm for translations and was 0.09° for internal-external rotations. V3MA precision ranged between 0.01 and 0.06 mm for translations and 0.02 to 0.07° for rotations. RSA precision ranged between 0.00 and 0.06 mm for translations and 0.04 to 0.25° for rotations. V3MA was successful in 6 clinical cases and no systematic bias was present. In conclusion, the accuracy and precision of V3MA were similar to RSA. Therefore, V3MA is a promising alternative to RSA in migration measurements of tibial components in TKA.
放射性立体测量分析（RSA）是目前用于确定植入物移位的金标准，但它需要骨标志物和特殊设备。因此，我们开发了体积匹配微动分析（V3MA），这是一种基于计算机断层扫描的放射性立体测量分析（CT-RSA）软件程序。本研究旨在确定V3MA在体外与RSA相比的准确性和精密度，并提供临床概念验证。将V3MA的准确性（均方根误差（RMSE））和精密度（标准差（SD））与RSA进行比较。将一个胫骨组件放置在一具尸体骨内的21个不同位置以评估准确性。为了评估精密度，对4具带有骨水泥固定胫骨组件的尸体骨进行了总共20次重复的零移位检查。在6例全膝关节置换术（TKA）患者中，使用V3MA和RSA测量了1至5年的移位情况。V3MA在平移方面的准确性范围为0.02至0.09毫米，内外旋转方面为0.01°。对于RSA，平移方面的准确性范围为0.03至0.09毫米，内外旋转方面为0.09°。V3MA在平移方面的精密度范围为0.01至0.06毫米，旋转方面为0.02至0.07°。RSA在平移方面的精密度范围为0.00至0.06毫米，旋转方面为0.04至0.25°。V3MA在6例临床病例中均成功，且不存在系统偏差。总之，V3MA的准确性和精密度与RSA相似。因此，在TKA中胫骨组件移位测量方面，V3MA是RSA的一个有前景的替代方法。
