Sternal instability measured with radiostereometric analysis. A study of method feasibility, accuracy and precision

Journal of Cardiothoracic Surgery
Rikke Falsig VestergaardMaiken Stilling

Abstract

A small, but unstable, saw-gap may hinder bone-bridging and induce development of painful sternal dehiscence. We propose the use of Radiostereometric Analysis (RSA) for evaluation of sternal instability and present a method validation. Four bone analogs (phantoms) were sternotomized and tantalum beads were inserted in each half. The models were reunited with wire cerclage and placed in a radiolucent separation device. Stereoradiographs (n = 48) of the phantoms in 3 positions were recorded at 4 imposed separation points. The accuracy and precision was compared statistically and presented as translations along the 3 orthogonal axes. 7 sternotomized patients were evaluated for clinical RSA precision by double-examination stereoradiographs (n = 28). In the phantom study, we found no systematic error (p > 0.3) between the three phantom positions, and precision for evaluation of sternal separation was 0.02 mm. Phantom accuracy was mean 0.13 mm (SD 0.25). In the clinical study, we found a detection limit of 0.42 mm for sternal separation and of 2 mm for anterior-posterior dislocation of the sternal halves for the individual patient. RSA is a precise and low-dose image modality feasible for clinical evaluation of sternal stability in r...Continue Reading

Associated Clinical Trials

References

Aug 1, 1989·Acta Orthopaedica Scandinavica·J Kärrholm
May 27, 1999·The Journal of Thoracic and Cardiovascular Surgery·W E McGregorJ A Magovern
Mar 13, 2002·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·Julian E LosanoffBruce W Richman
Aug 7, 2004·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·David H SongJai Raman
Oct 1, 2005·Acta Orthopaedica·Edward R ValstarJohan Kärrholm
Jul 11, 2006·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·R MadanatH T Aro
Oct 15, 2013·The Annals of Thoracic Surgery·Rikke F VestergaardJohn M Hasenkam
Mar 14, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Roshan P ShahScott Sporer

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Citations

Dec 21, 2019·Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine·Atte JoutsenJari Hyttinen

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Methods Mentioned

BETA
RSA

Software Mentioned

RSA

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