Brand R A, Yoder S A, Pedersen D R
Clin Orthop Relat Res. 1985 Jan-Feb(192):237-9.
Radiographs are commonly used to identify the loosened total hip reconstruction (THR), to plan revision surgery, and to evaluate long-term follow-up patients for study purposes. Interobserver variability was studied in an attempt to interpret 63 random follow-up films in a group of 93 patients eight to 12 years post-THR. Nine observations were made on the acetabular and femoral sides of the reconstructions on all films for a total of 567 observations. There was considerable disagreement in observations of the acetabular lucencies; a consensus of all three observers was obtained only 46% of the time. There was more uniform agreement among observers (87%) in analyzing the femoral side, although agreement was most frequent when there was no lucency. There was no difference in observer variables when greater lucencies were reported by one or more observers than when there were smaller lucencies. It was concluded that a single observer can reliably record a femoral observation of no lucency and, making allowances for the Mach effect, can reliably distinguish the presence or absence of a lucency. However, a single observer may not be able to make observations of acetabular lucencies with great reliability and, in contrast to femoral lucencies, a single observer may be less reliable in recording acetabular lucencies over 2 mm as compared with those under 2 mm.
X线片通常用于识别全髋关节置换术（THR）松动情况、规划翻修手术以及为研究目的评估长期随访患者。为解读一组93例患者在THR术后8至12年的63份随机随访影像，对观察者间的变异性进行了研究。在所有影像上，对重建的髋臼侧和股骨侧各进行9次观察，共计567次观察。在髋臼透亮区的观察上存在相当大的分歧；三位观察者达成一致意见的情况仅占46%。在分析股骨侧时，观察者之间的意见更为一致（87%），不过在没有透亮区时意见一致的情况最为常见。当一名或多名观察者报告的透亮区较大时与较小时相比，观察者变量并无差异。得出的结论是，单一观察者能够可靠地记录股骨侧无透亮区的观察结果，并且考虑到马赫效应，能够可靠地区分透亮区的有无。然而，单一观察者可能无法非常可靠地对髋臼透亮区进行观察，与股骨透亮区相比，单一观察者在记录大于2毫米的髋臼透亮区时可能不如记录小于2毫米的髋臼透亮区可靠。
