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General Orthopaedics

COMPARISON OF THE QUALITY OF MECHANICAL AXIS RADIOGRAPHS WITH EOS

The British Limb Reconstruction Society (BLRS) 2021 Annual Scientific Meeting, Virtual Conference, held online, 15 April 2021.



Abstract

Introduction

Low dose technology of an EOS scanner allows mechanical axis radiographs to be produced using a continuously moving x-ray emitting a thin beam to form a single image which includes all three joints, without the need for stitching. The aim of this study was to identify necessary improvements to enable effective interpretation of the radiographs, and to assess whether the quality of the radiographs varied by production method compared to a previous audit of CR and DR radiographs.

Materials and Methods

8 domains were identified based on a previous audit using the acronym MECHANIC each defining the qualities required for a radiograph to meet the criteria. 100 mechanical axis radiographs produced using conventional and digital methods were analysed in the original study to assess how many radiographs met the described criteria. The same criteria were amended and used to assess 123 different mechanical axis radiographs in the follow up study following the introduction of the EOS scanner, in which 77 were produced using EOS and 46 were produced using conventional and digital methods.

Results

The second study showed improvement in 2 of the 6 domains being assessed and the result remained the same in 1 domain, with a mean change of +2%. There was a large increase in the number of radiographs with impeccable stitching in the second study due to the use of the EOS scanner. When comparing the methods of production, there were a greater percentage of EOS radiographs meeting the criteria for each domain compared to conventional and digital radiographs. Those produced using the EOS scanner had a mean 0.83% more radiographs meeting the criteria per domain.

Conclusions

The overall quality of mechanical axis radiographs being produced has increased, but varies largely between the 6 domains. The EOS produced radiographs overall were of a greater quality than those produced using conventional and digital methods, but still had areas which required significant improvement.