Texture analysis of trabecular bone around RM-Pressfit cementless acetabulum in a series of 46 patients during a 5 year period

• Published in: Orthopaedics & traumatology, surgery & research surgery & research, 2019-11, Vol.105 (7), p.1283-1287
• Main Authors: Coupry, Augustin, Rony, Louis, Ducellier, Florian, Hubert, Laurent, Chappard, Daniel
• Format: Article
• Language: English
• Subjects: Acetabulum - diagnostic imaging; Acetabulum - surgery; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - instrumentation; Arthroplasty, Replacement, Hip - rehabilitation; Bone micro-architecture; Case-Control Studies; Female; Hip Prosthesis; Humans; Life Sciences; Male; Middle Aged; Retrospective Studies; RM-Pressfit® acetabulum; Texture analysis; Total hip arthroplasty
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2019.06.011

[Display omitted] Cementless total hip arthroplasty (THA) is a common procedure producing excellent clinical results. Their long-term survival is nevertheless burdened by loosening of the acetabular part caused by changes in the distribution of strains around the cup. In this context the RM-Pressfit® cup has been developed, resulting in a more harmonious distribution of the strains. Texture analysis of X-ray films can evaluate the evolution of trabecular bone micro-architecture during the five years following THA with a RM-Pressfit® cup. A monocentric series of 46 hips was reviewed regularly within five years post- surgery. Radiographic evaluation of the operated hip was done on frontal digitized radiographs of the pelvis to follow evolution of bone micro-architecture in the #2 zone of De Lee and Charnley. Texture analysis using fractal algorithms was done at D0, 6 months, 1, 2 and 5 years post-THA. The fractal methods used included the skyscrapers and the dynamic blanket methods with 3 different structuring elements (a cross, a horizontal and a vertical vector). The RM-Pressfit® caused significant changes in the distribution of strains around the acetabulum that preserved the bone volume over a 5-year period post-surgery. This corresponds to an improvement of the trabecular micro-architecture around the acetabular cups. A statistically significant increase in the four fractal dimensions considered corresponded to an improved trabecular bone micro-architecture revealed by texture analysis, a non-invasive method that can be used on digitized X-ray images. IIIb, Case control study, retrospective design.