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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2022, Number 6

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Acta Ortop Mex 2022; 36 (6)

Reproducibility and validity of radiographic measurements for the calculation of proximal femur morphometric indices predictive of hip fractures

Alarcón-Mendoza A, Berúmen-Nafarrete E, Monárrez-Espino J

Language: Spanish
References: 29
Page: 352-358
PDF size: 216.89 Kb.


ABSTRACT

Cross-sectional-retrospective study with 120 anteroposterior pelvic radiographs. Eight measurements were taken by three raters in two times to calculate the morphological-cortical (MCI), cortico-metaphyseal (CMI), and cortico-diaphysaire (CDI) indices. Intra/interobserver reproducibility was evaluated with the Bland-Altman method, and hip fracture occurrence was predicted by comparing cut-off points between raters maximizing sensitivity/specificity. The proportion of measurements outside ± 2 SD was similar for diameters/corticals (~5%), but exceeded 1 mm in some corticals, representing 10-20% of distances < 1 cm. Cut-off points fluctuated between 2.45 and 2.53 for MCI (3% difference), between 0.37 and 0.41 for CMI (12% difference), and between 0.23 and 0.33 for CDI (44% difference).


REFERENCES

  1. Egglestone A, Dietz-Collin G, Eardley W, Baker P. Chin-on-Chest in Neck of Femur Fracture (COCNOF) sign: A simple radiographic predictor of frailty and mortality in hip fracture patients. Injury. 2021; 52: 1494-9. Available in: https://doi.org/10.1016/j.injury.2020.10.098

  2. Saracco M, Maccauro G, Urbani A, Ciavardelli D, Persichilli S, Ancillai G, et al. Ceramic-on-metal bearing in short stem total hip arthroplasty: ions, functional and radiographic evaluation at mid-term follow-up. Hip Int. 2020; 30: 52-8. Available in: https://doi.org/10.1177/1120700020971661

  3. Tamaki T, Nakakita Y, Miura Y, Higashi H, Oinuma K, Shiratsuchi H. Radiographic factors to predict operation time of direct anterior total hip arthroplasty for dysplastic hips. Hip Int. 2021; 31: 90-6. Available in: https://doi.org/10.1177/1120700019873877

  4. Bigart KC, Nahhas CR, Ruzich GP, Culvern CN, Salzano MB, Della Valle CJ, et al. Does femoral morphology predict the risk of periprosthetic fracture after cementless total hip arthroplasty? J Arthroplasty. 2020; 35: S359-63. Available in: https://doi.org/10.1016/j.arth.2020.02.048

  5. Wilkerson J, Fernando ND. Classifications in Brief: The Dorr Classification of Femoral Bone. Clin Orthop Relat Res. 2020; 478: 1939-44. Available in: https://www.doi.org/10.1097/CORR.0000000000001295

  6. Nakaya R, Takao M, Hamada H, Sakai T, Sugano N. Reproducibility of the Dorr classification and its quantitative indices on plain radiographs. Orthop Traumatol Surg Res. 2019; 105: 17-21. Available in: https://doi.org/10.1016/j.otsr.2018.11.008

  7. Heale R, Twycross A. Validity and reliability in quantitative studies. Evid Based Nurs. 2015; 18: 66-7. Available in: http://dx.doi.org/10.1136/eb-2015-102129

  8. González-Macías J, del Pino-Montes J, Olmos JM, Nogués X. Guías de práctica clínica en la osteoporosis posmenopáusica, glucocorticoidea y del varón. Rev Clin Esp. 2015; 215: 515-26. Available in: http://dx.doi.org/10.1016/j.rce.2015.08.003

  9. Hernández HJM, Hernández HJJ, Marín ÁA, Cruz BA. Revisión bibliográfica del diagnóstico radiológico de fracturas patológicas. Rev Med Cos Cen. 2012; 69: 435-42. Available in: https://www.binasss.sa.cr/revistas/rmcc/603/art21.pdf

  10. Lozada Balderrama V, Alberto Infante OZ, Silva Escobedo JG, Velasco Leija A. Correlación radiológica entre el índice corticodiafisario y la densidad mineral ósea en el diagnóstico de la osteoporosis. Acta Ortop Mex. 2007; 21: 77-84. Available in: https://www.medigraphic.com/pdfs/ortope/or-2007/or072g.pdf

  11. Roberto Mora Zamarripa, Verduzco Rodriguera JJ, López Taylor J, Jáuregui Ulloa E, Cardona Muñoz I. Índice de Singh y morfológico-cortical en población adulta aparentemente sana, en deportistas y en individuos sedentarios. Acta Ortop Mex. 2001; 15: 186-8. Available in: https://www.medigraphic.com/pdfs/ortope/or-2001/or014g.pdf

  12. Sah AP, Thornhill TS, LeBoff MS, Glowacki J. Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int. 2007; 18: 1119-26. Available in: https://doi.org/10.1007/s00198-007-0348-6

  13. Milligan DJ, O'Brien S, Bennett D, Hill JC, Beverland DE. The effects of age gender on the diameter of the femoral canal in patients who undergo total hip replacement. Bone Joint J. 2013; 95-B: 339-42. Available in: https://doi.org/10.1302/0301-620X.95B3.30882

  14. Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville (MD): Office of the Surgeon General (US); 2004. Available in: https://www.ncbi.nlm.nih.gov/books/NBK45513/pdf/Bookshelf_NBK45513.pdf

  15. Rockwood CA, Green DP, Bucholz RW. Rockwood and Green's fractures in adults. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006.

  16. Gu Q, Koenig L, Mather RC 3rd, Tongue J. Surgery for hip fracture yields societal benefits that exceed the direct medical costs. Clin Orthop Relat Res. 2014; 472: 3536-46. Available in: https://www.doi.org/10.1007/s11999-014-3820-6

  17. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005; 16: S3-7. Available in: https://doi.org/10.1007/s00198-004-1702-6

  18. Lewiecki EM, Wright NC, Curtis JR, Siris E, Gagel RF, Saag KG, et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int. 2018; 29: 717-22. Available in: https://doi.org/10.1007/s00198-017-4345-0

  19. Altman DG, Bland JM. Measurement in medicine: the analysis of method comparison studies. Statistician. 1983; 32: 307-7. Available in: https://www.doi.org/10.2307/2987937

  20. Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999; 8: 135-60. Available in: 10.1177/096228029900800204

  21. Jensen T, Hansen M, Jensen KE, Podenphant J, Hansen TM, Hyldstrup L. Comparison of dual X-ray absorptiometry (DXA), digital X-ray radiogrammetry (DXR), and conventional radiographs in the evaluation of osteoporosis and bone erosions in patients with rheumatoid arthritis. Scand J Rheumatol. 2005; 34: 27-33. Available in: https://doi.org/10.1080/03009740510017986

  22. Singh M, Nagrath AR, Maini PS: Changes in trabecular pattern of the upper end of the femur as an index osteoporosis. J Bone Joint Surg. 1970; 52: 457-67. Available in: https://doi.org/10.2106/00004623-197052030-00005

  23. Sah AP, Thornhill TS, LeBoff MS, Glowacki J. Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int. 2007; 18: 1119-26. Available in: https://doi.org/10.1007/s00198-007-0348-6

  24. Karlsson KM, Sernbo I, Obrant KJ, Redlund-Johnell I, Johnell O. Femoral neck geometry and radiographic signs of osteoporosis as predictors of hip fracture. Bone 1996; 18: 327-30. Available in: https://doi.org/10.1016/8756-3282(96)00004-x

  25. Pulkkinen P, Partanen J, Jalovaara P, Jamsa T. Combination of bone mineral density and upper femur geometry improves the prediction of hip fracture. Osteoporos Int. 2004; 15: 274-80. Available in: https://doi.org/10.1007/s00198-003-1556-3

  26. Rubin PJ, Leyvraz PE, Aubagniac JM, Argenson JN, Esteve P, de Roguin B. The morphology of the proximal femur: a three-dimensional radiographic analysis. J Bone Joint Surg. 1992; 74: 28-32. Available in: https://www.doi.org/10.1302/0301-620X.74B1.1732260

  27. Rubin PJ, Leyvraz PE, Heegaard JH. Radiological variations in the anatomical parameters of the proximal femur in relation to rotation. Fr J Orthop Surg. 1989; 75: 209-15.

  28. Mazhar FN, Jafari D, Nojoomi M, Mirzaei A, Tayebi H. Inter and intraobserver reliability of Dorr classification in proximal fémur morphology. Shafa Ortho J. 2018; 5: e64801. Available in: https://www.doi.org/10.5812/soj.64801

  29. Karayiannis PN, Cassidy RS, Hill JC, Dorr LD, Beverland DE. The relationship between canal diameter and the Dorr classification. J Arthroplasty. 2020; 35: 3204-7. Available in: https://www.doi.org/10.1016/j.arth.2020.05.066



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