Radiographic assessment around a highly porous titanium cup
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The aim of this study was to use digital tomosynthesis to determine radiolucent lines around a highly porous titanium cup (Tritanium) and to look into the clinical and radiographic factors that are associated with radiolucent lines on tomosynthesis.

Analysis included 55 patients who underwent total hip arthroplasty using a Tritanium cup, and digital tomosynthesis. Plain radiography were performed at 1 week, 6 months, 1 year, and 2 years after surgery. The radiolucent lines around the cup were measured on both DTS and plain radiography at each postoperative period.

Clinical evaluations were performed by the Japanese Orthopaedic Association hip disease evaluation questionnaire (JHEQ), and revision surgeries were examined. Based on the presence of radiolucent lines on digital tomosynthesis at 2 years postoperatively, patients were divided into RL (+) and RL (-) groups and investigated for related factors.

Results:
--There were 20 cases in the RL (+) group and 35 cases in the RL (-) group, and no revision surgeries were required.

--Statistically, there were more cases with radiolucent lines on digital tomosynthesis (45.4% at 1 week and 36.3% at 2 years) than on plain radiography (9.1% at 1 week and 9.1% at 2 years) at each postoperative point.

--Logistic analysis showed no significant associations between the presence of radiolucent lines at 2 years on digital tomosynthesis, and the JHEQ parameters of pain, movement, or mental status.

Finally, digital tomosynthesis found more radiolucent lines across the titanium cups than simple radiography in a short-term study lasting up to two years. The presence of radiolucent lines has no bearing on the clinical assessment performed after surgery.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02396-4
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