A Comparison of Radiographic and Scintigraphic Techniques to Assess Aseptic Loosening of the Acetabular Component in a Total Hip Replacement

Temmerman, Olivier P.P.; Raijmakers, Pieter; David, Erik; Pijpers, Rik; Molenaar, Marinus A.; Hoekstra, Otto S.; Berkhof, Johannes; Manoliu, Radu A.; Teule, G. J. J.; Heyligers, Ide C.

doi:10.2106/00004623-200411000-00015

Cited by 43 publications

(24 citation statements)

References 16 publications

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“…It should be noted that substantial interobserver variability exists in assessment of periprosthetic lucency. Prior studies have indicated kappa = 0.37 or a rate of consensus of 46% for acetabular components and 87% consensus for femoral components [4,24]. Additional tests were obtained as needed, eg, CT scan to evaluate for occult periprosthetic fracture or laboratory studies and aspiration to evaluate possible infectious etiology.…”

Section: Methodsmentioning

confidence: 99%

The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing

Bartelt

Yuan

Trousdale

et al. 2010

Clinical Orthopaedics &Amp; Related Research

112

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Background Groin pain after total hip arthroplasty (THA) or total hip resurfacing arthroplasty can be troubling for patients and surgeons. Potential sources of pain include infection, loosening, metal hypersensitivity, or impingement of bony structures or the iliopsoas tendon. Questions/purposes We compared the rate of groin pain after THA or hip resurfacing using metal-on-metal to those of other bearing surfaces. Methods We identified 347 (334 patients) primary total hip (n = 301) or resurfacing (n = 46) arthroplasties. Complete preoperative, operative, and postoperative data were available for 282 hips. We retrospectively reviewed the charts for the presence or absence of groin pain at a minimum of 1 year after surgery with a specific focus on etiologic factors. The minimum followup was 12 months (mean, 14 months; range 12 to 24 months). Results The rate of groin pain was 7% (15 of 217 patients) after THA with conventional bearing surfaces, 15% (4 of 26 patients) with metal-on-metal THA and 18% (7 of 39 patients) with total hip resurfacing. Younger patients were more likely to report groin pain postoperatively and more likely to have metal-on-metal bearing surfaces.Conclusions Our data at short-term followup suggest increased rates of groin pain after metal-on-metal THA or resurfacing arthroplasty versus THA using polyethylene or ceramic bearing surfaces. The reasons are not clear but they appear to be associated with younger age. Potential factors include impingement, activity level and possibly higher expectations for patients receiving metal-on-metal bearing surfaces that may make those patients more likely to report postoperative pain.

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Section: Methodsmentioning

confidence: 99%

The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing

Bartelt

Yuan

Trousdale

et al. 2010

Clinical Orthopaedics &Amp; Related Research

112

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“…Thus publications to date on planar RNA of acetabular cups show poor results. Temmerman et al [3] in their series comparing with plain X-rays and digital subtraction arthrography, showed that planar RNA had a sensitivity of 57% and specificity of 67%. Planar RNA has not been sufficiently accurate to use Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The literature to date on radionuclide arthrography (RNA) has described the use of planar but not tomographic imaging. Studies using planar RNA for assessment of acetabular cup loosening showed inferior accuracy figures [2][3][4][5], and concluded that it is not a suitable technique on its own. We were unable to find published accounts of RNA using SPECT with or without CT image fusion for the evaluation of acetabular cup loosening.…”

Section: Introductionmentioning

confidence: 99%

Radionuclide arthrogram with SPECT/CT for the evaluation of mechanical loosening of hip and knee prostheses

et al. 2010

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For evaluation of mechanical loosening of the hip prosthesis SPECT/CT was significantly better than planar scanning for the acetabular cup, but not for the femoral stem. For evaluation of the knee prosthesis, a significant improvement was noted using SPECT/CT for the femoral component, and although superior results were also noted for the tibial component, statistical significance was not reached. Taking into account the limitations of this retrospective audit, the value of using RNA SPECT/CT appeared to lie in the exclusion of mechanical loosening.

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“…Digital subtraction techniques can be used to increase the sensitivity. Temmerman et al found an increased sensitivity of 15 % compared to conventional nuclear arthrography for the examination of the acetabular component (Temmerman et al, 2004). In contrast to this optimization, arthrography is identified to be non specific for the acetabular component (Köster et al, 1993).…”

Section: Arthrographymentioning

confidence: 99%

Current Possibilities for Detection of Loosening of Total Hip Replacements and How Intelligent Implants Could Improve Diagnostic Accuracy

Ruther¹,

Timm²,

Ewald³

et al. 2012

Recent Advances in Arthroplasty

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A Comparison of Radiographic and Scintigraphic Techniques to Assess Aseptic Loosening of the Acetabular Component in a Total Hip Replacement

Cited by 43 publications

References 16 publications

The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing

The Prevalence of Groin Pain After Metal-on-Metal Total Hip Arthroplasty and Total Hip Resurfacing

Radionuclide arthrogram with SPECT/CT for the evaluation of mechanical loosening of hip and knee prostheses

Current Possibilities for Detection of Loosening of Total Hip Replacements and How Intelligent Implants Could Improve Diagnostic Accuracy

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