Use of CT and 3D reconstruction for paprosky classification of acetabular bone loss after total hip arthroplasty

Accurate classification of acetabular bone loss in revision total hip arthroplasty (THA) is critical for surgical planning. The Paprosky classification, traditionally based on radiographs, has limited investigation regarding its application with computed tomography (CT) and three-dimensional (3D) reconstructions. CT images and 3D reconstructions created using Siemens syngo.via software were obtained from revision THA cases exhibiting postoperative acetabular bone loss. Metal artifacts were minimized via software editing. Images were classified according to the Paprosky system. Enhanced CT and 3D reconstructions provided clear visualization of defects across Paprosky types (I to IIIB). Improved anatomical detail permitted precise defect characterization, notably in the medial wall, acetabular rim, teardrop, and Kohler line. These details facilitated better assessment of defect location, orientation, and extent. Utilizing CT and 3D reconstructions significantly improves accuracy in categorizing acetabular bone defects using the Paprosky classification compared to traditional X-rays. Standardizing protocols to optimize image quality and artifact reduction is recommended to enhance surgical planning.