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Reliability of two different measuring techniques with computer tomography for penetration and distribution of cement in the proximal tibia after total knee arthroplasty

BMC Musculoskeletal Disorders Jun 17, 2020

Verburg H, van Zeeland Koobs L, Niesten DD, et al. - In this study, the reliability of two different techniques were tested for assessing penetration and distribution of the cement mantle in the proximal tibia after total knee arthroplasty with CT in vivo. Researchers taken standardized CT scans of the proximal tibia 1 to 2 years after total knee arthroplasties implanted with a surface cementing technique. They classified these prospectively acquired transversal CT images of the surface of the proximal tibia into four quadrants and were evaluated once manually and once with a numerical computing program (MATLAB® Update 2, The MathWorks, Inc.) based on Hounsfield Units by one of the researchers. Applying Kruskall-Wallis tests with multiple pairwise comparisons (Dunn’s test), differences between the quadrants were ascertained. They further evaluated intra- and inter-rater reliability as well as the inter method reliability with the Intraclass Correlation Coefficient per level of depth and with Bland-Altman plots. This analysis enrolled a sum of 92 CT scans. The findings reveal that in a total knee arthroplasty, distribution and penetration of cement in the proximal tibia can be assessed reliably with CT in combination with the matlab technique presented in this manuscript. This procedure can be applied for clinical purposes as well as for scientific research.

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