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Image analysis of wear in total hip replacements

This paper outlines an image analysis algorithm for the semi-automatic measurement of wear in the cemented, Charnley total hip replacement. The wear results from a retrospective study of 72 implants are compared with measurements from a manual radiographic technique and with direct measurements taken from the explanted sockets. Previous research into the application of image analysis to radiographic images, produced from laboratory specimens, had shown substantial improvements in levels of precision and repeatability over manual techniques, for metal backed sockets. However, the results presented here illustrate that in clinical practice, the usefulness of these techniques maybe substantially reduced due to factors that cannot be corrected for by the measurement process itself, especially prostheses that comprise of cemented, all-polyethylene sockets.