Radiographic wear measurements in a cementless metal-backed modular cobalt-chromium acetabular component

Linear polyethylene wear was measured radiographically and correlated with direct measurements of wear from 21 of 24 liners retrieved at revision. An optical comparator was used to assess linear wear using the shadowgraph technique. Postoperative and prerevision radiographs were reviewed to measure the amount of linear wear radiographically. Seven radiographic methods described in the literature were used: 5 were manual techniques, and 2 techniques used a computer-assisted digitizer. Linear regression analysis showed that there was a statistically significant correlation between the radiographic measurements compared with the direct measurement for 4 of the 5 manual techniques but only 1 of the 2 computerized techniques. Based on these results, radiographic wear measurements of cementless, modular components should be considered qualitative rather than quantitative. There is a significant difference in the measurements obtained among various published techniques. The addition of computer digitization to enhance manual methodology does not improve accuracy.