Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA
Background: A fully automated artificial intelligence–based tool was developed to detect and quantify femoral component subsidence between serial radiographs. However, it did not account for measurement errors due to leg position differences, such as rotation or flexion, between comparative radiogra...
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Elsevier
2024-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002383 |
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| author | Elizabeth S. Kaji, BA Austin F. Grove, BA Eva Lehtonen, MD Kellen L. Mulford, PhD Pouria Rouzrokh, MD, MPH, MHPE Charles P. Hannon, MD, MBA Michael J. Taunton, MD Cody C. Wyles, MD |
| author_facet | Elizabeth S. Kaji, BA Austin F. Grove, BA Eva Lehtonen, MD Kellen L. Mulford, PhD Pouria Rouzrokh, MD, MPH, MHPE Charles P. Hannon, MD, MBA Michael J. Taunton, MD Cody C. Wyles, MD |
| author_sort | Elizabeth S. Kaji, BA |
| collection | DOAJ |
| description | Background: A fully automated artificial intelligence–based tool was developed to detect and quantify femoral component subsidence between serial radiographs. However, it did not account for measurement errors due to leg position differences, such as rotation or flexion, between comparative radiographs. If there are small differences in rotation or flexion of the leg between comparative radiographs, the impact on subsidence measurement is unclear. Methods: Twenty-five primary total hip arthroplasty procedures were performed by 3 fellowship-trained arthroplasty surgeons using a direct anterior approach. A Hana table allowed precise changes in femur position. Final fluoroscopic images were collected with rotational and flexion changes applied to the femur without moving the C-arm. Subsidence values were manually measured and compared across different positions. Results: Variations in greater trochanter to tip of the stem measurements between the neutral position and rotations were minimal, measuring <1 mm on an absolute scale and <1% on a relative scale. These differences decreased as the femur was rotated from an external rotation of 20° to an internal rotation of 20°. Notable variances exceeding 5 mm were observed in the 10° flexion position compared to neutral. Conclusions: Minor changes (20° or less) in leg rotation between serial radiographs are unlikely to significantly affect the greater trochanter to tip of the stem measurement, whereas flexion is highly impactful. These findings suggest that the fully automated artificial intelligence–based tool for detecting and quantifying femoral component subsidence is robust against rotational variations but may be susceptible to significant measurement errors if there are considerable changes in leg flexion between comparative radiographs. |
| format | Article |
| id | doaj-art-65bb6287d98a4d4ba8522840a0fc6237 |
| institution | OA Journals |
| issn | 2352-3441 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-65bb6287d98a4d4ba8522840a0fc62372025-08-20T02:37:24ZengElsevierArthroplasty Today2352-34412024-12-013010155310.1016/j.artd.2024.101553Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THAElizabeth S. Kaji, BA0Austin F. Grove, BA1Eva Lehtonen, MD2Kellen L. Mulford, PhD3Pouria Rouzrokh, MD, MPH, MHPE4Charles P. Hannon, MD, MBA5Michael J. Taunton, MD6Cody C. Wyles, MD7Orthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAOrthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAMayo Clinic Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAOrthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAOrthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Radiology Informatics Laboratory, Mayo Clinic Department of Radiology, Mayo Clinic, Rochester, MN, USAMayo Clinic Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAOrthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAOrthopedic Surgery Artificial Intelligence Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Mayo Clinic Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Corresponding author. Department of Orthopedic Surgery, Mayo Clinic Rochester, 200 1st St. SW, Rochester, MN 55905, USA. Tel.: +1 507 284 2511.Background: A fully automated artificial intelligence–based tool was developed to detect and quantify femoral component subsidence between serial radiographs. However, it did not account for measurement errors due to leg position differences, such as rotation or flexion, between comparative radiographs. If there are small differences in rotation or flexion of the leg between comparative radiographs, the impact on subsidence measurement is unclear. Methods: Twenty-five primary total hip arthroplasty procedures were performed by 3 fellowship-trained arthroplasty surgeons using a direct anterior approach. A Hana table allowed precise changes in femur position. Final fluoroscopic images were collected with rotational and flexion changes applied to the femur without moving the C-arm. Subsidence values were manually measured and compared across different positions. Results: Variations in greater trochanter to tip of the stem measurements between the neutral position and rotations were minimal, measuring <1 mm on an absolute scale and <1% on a relative scale. These differences decreased as the femur was rotated from an external rotation of 20° to an internal rotation of 20°. Notable variances exceeding 5 mm were observed in the 10° flexion position compared to neutral. Conclusions: Minor changes (20° or less) in leg rotation between serial radiographs are unlikely to significantly affect the greater trochanter to tip of the stem measurement, whereas flexion is highly impactful. These findings suggest that the fully automated artificial intelligence–based tool for detecting and quantifying femoral component subsidence is robust against rotational variations but may be susceptible to significant measurement errors if there are considerable changes in leg flexion between comparative radiographs.http://www.sciencedirect.com/science/article/pii/S2352344124002383Total hip arthroplastyProsthesis looseningRadiographic measurementsArtificial intelligenceAutomatic calculatorSubsidence |
| spellingShingle | Elizabeth S. Kaji, BA Austin F. Grove, BA Eva Lehtonen, MD Kellen L. Mulford, PhD Pouria Rouzrokh, MD, MPH, MHPE Charles P. Hannon, MD, MBA Michael J. Taunton, MD Cody C. Wyles, MD Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA Arthroplasty Today Total hip arthroplasty Prosthesis loosening Radiographic measurements Artificial intelligence Automatic calculator Subsidence |
| title | Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA |
| title_full | Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA |
| title_fullStr | Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA |
| title_full_unstemmed | Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA |
| title_short | Impact of Leg Position on Measurements Used to Detect Femoral Component Subsidence in THA |
| title_sort | impact of leg position on measurements used to detect femoral component subsidence in tha |
| topic | Total hip arthroplasty Prosthesis loosening Radiographic measurements Artificial intelligence Automatic calculator Subsidence |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002383 |
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