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The Bone & Joint Journal
Vol. 99-B, Issue 4 | Pages 421 - 431
1 Apr 2017
Veldman HD Heyligers IC Grimm B Boymans TAEJ

Aims

Our aim was to prepare a systematic review and meta-analysis to compare the outcomes of cemented and cementless hemiarthroplasty of the hip, in elderly patients with a fracture of the femoral neck, to investigate the mortality, complications, length of stay in hospital, blood loss, operating time and functional results.

Materials and Methods

A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on randomised controlled trials (RCTs), studying current generation designs of stem only. The synthesis of results was done of pooled data, with a fixed effects or random effects model, based on heterogeneity.


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 1 | Pages 136 - 141
1 Jan 2010
Franken M Grimm B Heyligers I

We have investigated the accuracy of the templating of digital radiographs in planning total hip replacement using two common object-based calibration methods with the ball placed laterally (method 1) or medially (method 2) and compared them with two non-object-based methods. The latter comprised the application of a fixed magnification of 121% (method 3) and calculation of magnification based on the object-film-distance (method 4). We studied the post-operative radiographs of 57 patients (19 men, 38 women, mean age 73 years (53 to 89)) using the measured diameter of the prosthetic femoral head and comparing it with the true value.

Both object-based methods (1 and 2) produced large errors (mean/maximum: 2.55%/17.4% and 2.04%/6.46%, respectively). Method 3 applying a fixed magnification and method 4 (object-film-distance) produced smaller errors (mean/maximum 1.42%/5.22% and 1.57%/4.24%, respectively; p < 0.01). The latter results were clinically relevant and acceptable when planning was allowed to within one implant size. Object-based calibration (methods 1 and 2) has fundamental problems with the correct placement of the calibration ball. The accuracy of the fixed magnification (method 3) matched that of object-film-distance (method 4) and was the most reliable and efficient calibration method in digital templating.


The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 7 | Pages 839 - 846
1 Jul 2008
Geerdink CH Grimm B Vencken W Heyligers IC Tonino AJ

We have compared four computer-assisted methods to measure penetration of the femoral head into the acetabular component in total hip replacement. These were the Martell Hip Analysis suite 7.14, Rogan HyperOrtho, Rogan View Pro-X and Roman v1.70. The images used for the investigation comprised 24 anteroposterior digital radiographs and 24 conventional acetate radiographs which were scanned to provide digital images. These radiographs were acquired from 24 patients with an uncemented total hip replacement with a follow-up of approximately eight years (mean 8.1; 6.3 to 9.1). Each image was measured twice by two blinded observers. The mean annual rates of penetration of the femoral head measured in the eight-year single image analysis were: Martell, 0.24 (SD 0.19); HyperOrtho, 0.12 (SD 0.08); View Pro-X, 0.12 (SD 0.06); Roman, 0.12 (SD 0.07). In paired analysis of the six-month and eight-year radiographs: Martell, 0.35 (SD 0.22); HyperOrtho, 0.15 (SD 0.13); View Pro-X, 0.11 (SD 0.06); Roman, 0.11 (SD 0.07). The intra- and inter-observer variability for the paired analysis was best for View Pro-X and Roman software, with intraclass correlations of 0.97, 0.87 and 0.96, 0.87, respectively, and worst for HyperOrtho and Martell, with intraclass correlations of 0.46, 0.13 and 0.33, 0.39, respectively.

The Roman method proved the most precise and the most easy to use in clinical practice and the software is available free of charge. The Martell method showed the lowest precision, indicating a problem with its edge detection algorithm on digital images.