Radiographic Assessment of Bone Quality Using 4 Radiographic Indexes: Canal Diaphysis Ratio Is Superior

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dc.contributor.authorFaundez, Jorge
dc.contributor.authorCarmona, Maximiliano
dc.contributor.authorKlaber, Ianiv
dc.contributor.authorZamora, Tomas
dc.contributor.authorBotello, Eduardo
dc.contributor.authorSchweitzer, Daniel
dc.date.accessioned2025-01-20T17:09:21Z
dc.date.available2025-01-20T17:09:21Z
dc.date.issued2024
dc.description.abstractBackground: Osteoporosis increases the risk of periprosthetic fracture and loosening in hip arthroplasty. Many methods have been proposed to assess bone quality in X-rays, including both qualitative such as the Dorr classification and quantitative such as the Calcar-Canal Ratio (CCR) and Cortical -Thickness index/Canal-Bone ratio (CTI/CBR). The Canal-Diaphysis ratio (CDR) has been described as a predictor for hip fragility fractures; however, its relationship with bone mineral density (BMD) has not been described. The purpose of this study was to evaluate the correlation of the Dorr classification, CCR, CTI/CBR, and CDR with BMD of the proximal femur in patients without hip fracture. Methods: Forty-seven patients over 45 years of age who had less than 6 months between radiographs and dual -energy X-ray absorptiometry were evaluated. Measurements of CCR, CBR, CDR, and Dorr classification were performed in all radiographs by 2 independent observers. Results: The CDR had a high correlation (r = 0.74, P=<0.01) with BMD, whereas the CTI/CBR had a moderate correlation (r = 0.49, P=<0.01), and the CCR had no correlation with BMD (r = 0.06, P = .96). When evaluating the receiver operating characteristic curve, CDR showed the best performance (area under curve [AUC] = 0.75) followed by CBR (AUC = 0.73) and CCR (AUC = 0.61). The optimal cutoff value for the CDR was 0.49, with 100% sensitivity and 58% specificity. The inter- and intra-observer variability was good for all methods. No differences were found between Dorr classification of patients who had or did not have osteoporosis. Conclusion: Of all the analyzed methods, the CDR was found to have the best correlation with BMD. This study proposes the use of CDR as a tool for assessing bone quality when deciding the implant fixation method in hip arthroplasty. (c) 2023 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.arth.2023.08.037
dc.identifier.eissn1532-8406
dc.identifier.issn0883-5403
dc.identifier.urihttps://doi.org/10.1016/j.arth.2023.08.037
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/91035
dc.identifier.wosidWOS:001155475700001
dc.issue.numero2
dc.language.isoen
dc.pagina.final432
dc.pagina.inicio427
dc.revistaJournal of arthroplasty
dc.rightsacceso restringido
dc.subjectbone mineral density
dc.subjectosteoporosis
dc.subjecttotal hip arthroplasty
dc.subjectcanal bone ratio
dc.subjectcanal diaphysis index
dc.subjectcanal calcar ratio
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRadiographic Assessment of Bone Quality Using 4 Radiographic Indexes: Canal Diaphysis Ratio Is Superior
dc.typeartículo
dc.volumen39
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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