Kyu-Chong Lee, Joo Hui Kim, Seok Ha Hong, Kyung-Sik Ahn, Yongwon Cho, Woo Young Kang, Baek Hyun Kim, Euddeum Shim, Seung Beom Han, Chang Ho Kang
{"title":"Clinical feasibility of camera-type X-ray for intraoperative imaging of hip arthroplasty: a pilot study.","authors":"Kyu-Chong Lee, Joo Hui Kim, Seok Ha Hong, Kyung-Sik Ahn, Yongwon Cho, Woo Young Kang, Baek Hyun Kim, Euddeum Shim, Seung Beom Han, Chang Ho Kang","doi":"10.1007/s00256-026-05331-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical feasibility of a camera-type X-ray system, compared with conventional portable X-ray, for intraoperative imaging during hip arthroplasty.</p><p><strong>Materials and methods: </strong>Twenty-one patients who underwent hip arthroplasty were prospectively enrolled. Conventional portable and camera-type X-ray images were obtained intraoperatively (n = 42). Three reviewers (two radiologists and one orthopedic surgeon) independently assessed image quality and diagnostic confidence using 4-point Likert scales, as well as the feasibility of assessing leg length discrepancies (LLD), calculated as the difference between the transischial line and the lesser trochanter (TI-LT). Two radiologists also measured the TI-LT interval in both modalities. Image quality and diagnostic confidence were compared using the Wilcoxon rank-sum test. The feasibility of LLD assessment was analyzed using Fisher's exact test. The agreement between camera-type and portable X-ray measurements was evaluated using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>Image quality scores were significantly higher for portable X-rays than for camera-type X-rays (mean ± SD, 3.65 ± 0.44 vs. 2.57 ± 0.89; p < 0.001). Diagnostic confidence was also higher with the portable X-rays (3.86 ± 0.27 vs. 2.95 ± 0.91; p < 0.001). However, the feasibility of the LLD assessment did not differ significantly between the two modalities for any reviewer (all p > 0.1). The TI-LT interval measurements demonstrated good agreement between camera-type and portable X-rays, with an ICC of 0.750 (95% CI 0.454-0.898).</p><p><strong>Conclusions: </strong>Although conventional portable X-rays provided superior image quality and diagnostic confidence, camera-type X-rays demonstrated comparable feasibility for intraoperative evaluation of LLD and good agreement in quantitative measurements. These findings support the clinical feasibility of using camera-type X-rays for intraoperative imaging during hip arthroplasty.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2907-2917"},"PeriodicalIF":2.5000,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skeletal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00256-026-05331-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/8/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To evaluate the clinical feasibility of a camera-type X-ray system, compared with conventional portable X-ray, for intraoperative imaging during hip arthroplasty.
Materials and methods: Twenty-one patients who underwent hip arthroplasty were prospectively enrolled. Conventional portable and camera-type X-ray images were obtained intraoperatively (n = 42). Three reviewers (two radiologists and one orthopedic surgeon) independently assessed image quality and diagnostic confidence using 4-point Likert scales, as well as the feasibility of assessing leg length discrepancies (LLD), calculated as the difference between the transischial line and the lesser trochanter (TI-LT). Two radiologists also measured the TI-LT interval in both modalities. Image quality and diagnostic confidence were compared using the Wilcoxon rank-sum test. The feasibility of LLD assessment was analyzed using Fisher's exact test. The agreement between camera-type and portable X-ray measurements was evaluated using intraclass correlation coefficients (ICCs).
Results: Image quality scores were significantly higher for portable X-rays than for camera-type X-rays (mean ± SD, 3.65 ± 0.44 vs. 2.57 ± 0.89; p < 0.001). Diagnostic confidence was also higher with the portable X-rays (3.86 ± 0.27 vs. 2.95 ± 0.91; p < 0.001). However, the feasibility of the LLD assessment did not differ significantly between the two modalities for any reviewer (all p > 0.1). The TI-LT interval measurements demonstrated good agreement between camera-type and portable X-rays, with an ICC of 0.750 (95% CI 0.454-0.898).
Conclusions: Although conventional portable X-rays provided superior image quality and diagnostic confidence, camera-type X-rays demonstrated comparable feasibility for intraoperative evaluation of LLD and good agreement in quantitative measurements. These findings support the clinical feasibility of using camera-type X-rays for intraoperative imaging during hip arthroplasty.
期刊介绍:
Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration.
This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.