Johnston et al. (1990) present CART (Clinical And Radiographic Terminology), a consensus-derived standard for reporting THA outcomes. Endorsed by the Hip Society, SICOT, and AAOS, it defines unalterable terminology for patient data, clinical evaluation, and radiographic assessment. The goal: enable meaningful comparison across studies by giving surgeons a common language.
Two decades of THA literature before 1990 used inconsistent terminology, variable follow-up, and roughly 20 different rating scales. Galante declared in 1985 that standardization was urgent — CART was the direct answer.
When you read any hip arthroplasty series, the radiographic language traces back here. Gruen zones 1–7 on AP and zones 8–14 on lateral, DeLee-Charnley acetabular zones, Brooker ectopic ossification grades. These are CART-codified terms you will use every time you dictate a postoperative hip note or interpret a loosening workup.
The loosening hierarchy matters clinically: migration or cement fracture means the implant is definitely loose; femoral prosthesis-cement radiolucency means probably loose (indirect sign); cement-bone radiolucency of any width means watch it, because significance is unknown but concern scales with width and extent.
CARTalso demonstrated that a single standardized dataset can generate any of the four major hip scores. Meaning the data collection effort is the same regardless of which score your institution prefers.
Johnston et al. (1990) present CART (Clinical And Radiographic Terminology), a consensus-derived standard for reporting THA outcomes. Endorsed by the Hip Society, SICOT, and AAOS, it defines unalterable terminology for patient data, clinical evaluation, and radiographic assessment. The goal: enable meaningful comparison across studies by giving surgeons a common language.
Two decades of THA literature before 1990 used inconsistent terminology, variable follow-up, and roughly 20 different rating scales. Galante declared in 1985 that standardization was urgent — CART was the direct answer.
When you read any hip arthroplasty series, the radiographic language traces back here. Gruen zones 1–7 on AP and zones 8–14 on lateral, DeLee-Charnley acetabular zones, Brooker ectopic ossification grades. These are CART-codified terms you will use every time you dictate a postoperative hip note or interpret a loosening workup.
The loosening hierarchy matters clinically: migration or cement fracture means the implant is definitely loose; femoral prosthesis-cement radiolucency means probably loose (indirect sign); cement-bone radiolucency of any width means watch it, because significance is unknown but concern scales with width and extent.
CARTalso demonstrated that a single standardized dataset can generate any of the four major hip scores. Meaning the data collection effort is the same regardless of which score your institution prefers.