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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 5, 741-744.
doi: 10.1302/0301-620X.87B5.15377  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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EBRA-FCA for measurement of migration of the femoral component in surface arthroplasty of the hip

P. E. Beaulé, MD, FRCSE, Assistant Clinical Professor1; M. Krismer, MD, Professor2; P. Mayrhofer, PhD, Assistant Professor3; S. Wanner, MD, Registrar2; M. Le Duff, MA, Clinical Research Coordinator1; M. Mattesich, MD, Registrar2; B. Stoeckl, MD, Senior Consultant2; H. C. Amstutz, MD, Medical Director1; and R. Biedermann, MD, Senior Consultant2

1 Joint Replacement Institute at the Orthopaedic Hospital, Los Angeles, California 90007, USA
2 Department of Orthopaedics, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
3 Institute of Mathematics and Geometry, University of Innsbruck, Technikerstrasse 113, A-6020 Innsbruck, Austria.

Correspondence should be sent to Dr P. E. Beaulé at the Department of Orthopaedics, David Geffen School of Medicine, UCLA, 1245 16th Street, Suite 202, Santa Monica, California 90404; e-mail: pbeaule{at}laoh.ucla.edu

Studies on the migration of an implant may be the only way of monitoring the early performance of metal-on-metal prostheses. The Ein Bild Roentgen Analyse - femoral component analysis (EBRA-FCA) method was adapted to measure migration of the femoral component in a metal-on-metal surface arthroplasty of the hip using standard antero-posterior radiographs. In order to determine the accuracy and precision of this method a prosthesis was implanted into cadaver bones. Eleven series of radiographs were used to perform a zero-migration study. After adjustment of the femoral component to simulate migration of 3 mm the radiographs were repeated. All were measured independently by three different observers.

The accuracy of the method was found to be ± 1.6 mm for the x-direction and ± 2 mm for the y-direction (95% percentile). The method was validated using 28 hips with a minimum follow-up of 3.5 years after arthroplasty. Seventeen were sound, but 11 had failed because of loosening of the femoral component. The normal (control) group had a different pattern of migration compared with that of the loose group. At 29.2 months, the control group showed a mean migration of 1.62 mm and 1.05 mm compared with 4.39 mm and 4.05 mm in the failed group, for the centre of the head and the tip of the stem, respectively (p = 0.001). In the failed group, the mean time to migration greater than 2 mm was earlier than the onset of clinical symptoms or radiological evidence of failure, 19.1 versus 32.2 months (p = 0.001) and 24.8 months (p = 0.012), respectively.

EBRA-FCA is a reliable and valid tool for measuring migration of the femoral component after surface arthroplasty and can be used to predict early failure of the implant. It may be of value in determining the long-term performance of surface arthroplasty.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General