Background: Polyethylene wear is considered a most important part of periprosthetic osteolysis development. Thus, its measurement is central to contemporary orthopaedics.
Aims: The aim of this paper was to compare the accuracy of three radiographic techniques for wear measurement. Secondly, the influence of the abduction angle of the cup on measurement accuracy was investigated.
Methods: Wear was measured manually in 80 patients by a single observer according to the Livermore, Charnley, and Dorr description. A multi-component statistical analysis was used to test the hypothesis that the Livermore technique was superior. In vitro data obtained from a Universal-type measuring microscope served as a gold standard.
Results: In vitro measurements showed an average linear wear of 0.363 mm per year (0.000-0.939, SD 0.241) with a corresponding volumetric wear rate of 161 mm3 per year (0-467, SD 118.2). The Livermore technique showed the least deviation from the optical reference standard and a superior position from the viewpoint of error analysis but the correlation coefficient was slightly less (r = 0.761) than for the Dorr and Charnley techniques (r = 0.795 and r = 0.778, respectively). In addition, the mean error of the Dorr method differed significantly from zero (p = 0.036). Overall, the Livermore technique was the most accurate method for polyethylene wear measurement regardless of the abduction angle of the cup.
Conclusions: The Livermore technique performed manually was more accurate than the Charnley and Dorr methods. Nevertheless, we consider the Dorr technique an adequate tool for day-to-day wear measurements, mainly due to its simplicity.