Application of digital radiography and digital tomosynthesis in the postoperative evaluation of hip arthroplasty

To analyze the clinical utility of digital radiography (DR) and digital tomosynthesis (DTS) in the postoperative assessment of hip arthroplasty.

The data of 60 patients (71 hip joints) who underwent hip arthroplasty were retrospectively collected from an electronic information system. The DTS method was evaluated (advantages and disadvantages of different positions and image reconstruction techniques) and compared with the DR technique for postoperative assessment.

A total of 247 osteolysis zones were identified in the hip joint under the anteroposterior view, while 195 osteolysis zones were identified in the lateral-oblique view of the hip joint. The metal artifact reduction algorithm identified the highest number of osteolysis zones around the artificial acetabulum and femoral stem, outperforming the standard algorithm and high-contrast algorithm (P < 0.05). A total of 247 osteolysis zones were identified with DTS, whereas DR identified 185 osteolysis zones. In the inner superior zone (A2) and the pubic margin of the inner inferior zone (A31), the number of osteolysis zones identified by DTS was significantly higher than that of DR (P < 0.05). In the Gruen zones B1, B2, B3, B6, and B7, the number of osteolysis zones identified by DTS was significantly higher than that of DR (P < 0.05).

Under the anteroposterior view of the hip joint and using a metal artifact reduction algorithm, DTS detection reveals a greater number of osteolysis zones. It is recommended to use this imaging position and algorithm for postoperative evaluation of patients after hip arthroplasty.