Bone Density Measurement with IMAGE J-software in Primary Uncemented Total Hip Replacement.

Area of Science:

• Orthopaedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Cementless total hip arthroplasty (THA) success depends on mechanical stability and biological fixation.
• Assessing bone adaptation post-THA is crucial for long-term implant survival.
• Dual-energy X-ray absorptiometry (DEXA) and computed tomography (CT) are established assessment methods.

Purpose of the Study:

• To evaluate bone adaptation in cementless THA using a validated image analysis tool.
• To assess changes in bone density after THA using plain radiographs and ImageJ software.
• To determine the efficacy of ImageJ in quantifying osteointegration.

Main Methods:

• Prospective collection of clinical scores and X-rays from 155 patients undergoing cementless THA.
• Calculation of relative bone density (RBD) using the Rossler validated method with ImageJ software.
• Analysis of plain radiographs to assess bone adaptation and implant positioning.

Main Results:

• Mean follow-up of 38.5 months in 155 patients (mean age 56.4 years).
• Significant decrease in RBD observed in Gruen zone 1; other zones showed minor changes (-9% to +4%).
• All cups positioned within the Lewinnek safe zone; minor complications included radiolucent lines and two fractures.

Conclusions:

• ImageJ is a robust tool for quantitative assessment of osteointegration in uncemented hip implants.
• ImageJ analysis of standard X-rays offers precision for improved clinical outcomes.
• Routine use of ImageJ enhances understanding of bone-implant interactions, optimizing patient care and implant survival.