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01.11.2010 | Basic Research | Ausgabe 11/2010

Clinical Orthopaedics and Related Research® 11/2010

Use of Morphometry to Quantify Osteolysis after Total Hip Arthroplasty

Clinical Orthopaedics and Related Research® > Ausgabe 11/2010
MSc, MCSP Lindsay K. Smith, PhD, MCSP Fiona Cramp, PhD, MCSP Shea Palmer, PhD Nikki Coghill, MD, FRCS Robert F. Spencer
Wichtige Hinweise
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
This work was performed at Weston General Hospital and data analysis was conducted at the University of the West of England.



Progressive osteolysis threatens the longevity of hip arthroplasties and radiographic review is recommended. Measurement of osteolytic lesions in a clinical setting has not been achieved easily in the past. Other radiologic investigations provide accurate information but cost and risk to the patient prohibit their use in routine review.


We developed a simple, reliable tool to be used in hip arthroplasty review to quantify osteolytic changes seen on plain film radiographs.


A morphometric grid was developed and tested on simulated and actual osteolytic lesions. Four health professionals measured lesions on each of two occasions. Intraclass correlation coefficients (ICC) for interobserver and intraobserver reliabilities were calculated and Bland-Altman plots were constructed for graphic analysis.


The ICCs for interobserver reliability on the simulated and actual osteolytic lesions were in the range 0.90 to 0.96. The values for intraobserver (test-retest) reliability were 0.97 to 0.98. The Bland-Altman plots confirmed agreement and in each case, proximity of the mean to zero indicated no significant bias.


The data show a morphometric grid is reliable for measuring osteolytic changes after hip arthroplasty.

Clinical Relevance

This tool has potential to improve monitoring processes for hip arthroplasty and to be useful in future research studies. Additional work is needed to test for validity and clinical importance of the measurements obtained.

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