NDLI: A Three-dimensional Method for Evaluating Changes in Acetabular Osteolytic Lesions in Response to Treatment

Content Provider	PubMed Central
Author	Egawa, Hiroshi Ho, Henry Huynh, Cathy Hopper, Robert H. Engh, C. Anderson Engh, Charles A.
Abstract	The treatment of asymptomatic osteolysis among well-fixed cementless cups remains controversial. To compare the effectiveness of different treatment strategies, an objective technique for evaluating bone remodeling would be useful. By matching and comparing serial CT images with the aid of a computer-assisted imaging program, we developed a method to evaluate three-dimensional mineralization changes within osteolytic defects. Preoperative, immediate postoperative, and followup CT images were normalized based on a phantom with known densities and matched using image registration so that the same region could be analyzed on each image. New bone mineralization within the preoperative osteolytic lesion volume was quantified based on a patient-specific trabecular bone density threshold. As a pilot study, we applied this technique in 10 patients treated by polyethylene liner exchange with débridement and grafting of periacetabular osteolytic lesions using a calcium sulfate bone graft substitute. Relative to the preoperative osteolytic lesion volume, an average of 43% (range, 8%–72%) of each defect was filled with graft at revision. After resorption of the graft, an average of 24% (range, 9%–44%) of the original defect volume demonstrated evidence of new mineralization at 1-year followup. The amount of new mineralization was directly proportional (r2 = 0.70) to the defect filling achieved at revision. CT-based image analysis offers an objective method for quantifying three-dimensional bone remodeling and can be used to evaluate the effectiveness of osteolysis treatment strategies.
Related Links	http://dx.doi.org/10.1007/s11999-009-1050-0
Starting Page	480
File Format	PDF
ISSN	15281132
e-ISSN	15281132
Journal	Clinical Orthopaedics and Related Research
Issue Number	2
Volume Number	468
Language	English
Publisher	Springer-Verlag
Publisher Date	2010-02-01
Access Restriction	Open
Rights Holder	Springer-Verlag
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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