Appearance of septic hip prostheses on plain radiographs.

Tigges, Stefan; Stiles, R G; Roberson, James R.

doi:10.2214/ajr.163.2.8037035

Cited by 122 publications

(58 citation statements)

References 11 publications

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“…9 CT and MR scans are affected by metal implants. Conventional bone scintigraphy may reveal increased isotope uptake not only in infection, but also in the presence of mechanical loosening.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy

Nagoya

Kaya

Sasaki

et al. 2008

The Journal of Bone and Joint Surgery. British volume

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We evaluated triple-phase bone scintigraphy in the differential diagnosis of peri-prosthetic infection in 46 patients with a total hip replacement or bipolar hemiarthroplasty who were due for revision surgery. There were 18 men and 28 women, with a mean age at operation of 64.6 years (28 to 81). We defined peri-prosthetic infection as an increased uptake of radioisotope in all the phases of triple-phase bone scintigraphy and validated these results against the histological and/or microbiology results in every case.The positive and negative predictive values for the presence of infection were 83% and 93%, respectively. The diagnostic sensitivity was 88% and the specificity was 90%.This study indicates that triple-phase bone scintigraphy is a useful tool in the detection of peri-prosthetic infection and offers a cost-effective method of screening.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy

Nagoya

Kaya

Sasaki

et al. 2008

The Journal of Bone and Joint Surgery. British volume

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“…Radiographic signs include periostitis (periosteal reaction), endosteal scalloping, and ring osteolysis (focal resorption); infection is likely if there is rapid onset of osteolysis or endosteal scalloping in the absence of obvious mechanical causes such as poorly implanted prostheses and/or excessive polyethylene wear [28][29][30][31]; early implant loosening may alert for a dormant underlying infection [21]. Diagnosis of infection in an arthroplasty required: (1) clinical and/or analytical symptoms and signs (unexplainable pain and/or draining sinus and/or persistent local erythema plus swelling and/or CRP greater than 1 mg/dL and ESR greater than 30 mm in the first hour [Katz index]) as well as (2) microbiological confirmation (three or more positive cultures with the same organisms from intraoperative samples and/or cultures of joint aspiration).…”

Section: Methodsmentioning

confidence: 99%

Are Antibiotics Necessary in Hip Arthroplasty With Asymptomatic Bacteriuria? Seeding Risk With/Without Treatment

Cordero‐Ampuero

González-Fernández

Martínez-Vélez

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…One of the authors (MdD) and one radiologist (different radiologists from the radiology department of the hospital through the patients' years of followup) independently examined the radiographs for signs suggestive of infection or loosening. Radiographic signs suggestive of infection include periostitis (periosteal reaction), endosteal scalloping, and ring osteolysis (focal resorption); infection is likely if there is rapid onset of osteolysis or endosteal scalloping in the absence of obvious mechanical causes such as poorly implanted prostheses and/or excessive polyethylene wear [38,39,42]; early implant loosening may alert for a dormant underlying infection [31]. Radiographic signs suggestive of loosening include complete radiolucent lines, migration (change of [ 58 in the acetabular angle or change of [ 3 mm in the height of the center of the hip or the horizontal distance of the cup) [27] and stem subsidence (an increase of at least 5 mm in the distance between the top of the stem and the greater trochanter when the initial postoperative radiographs were compared to those made at the followup evaluations [12].…”

Section: Methodsmentioning

confidence: 99%

What Are the Risk Factors for Infection in Hemiarthroplasties and Total Hip Arthroplasties?

Cordero‐Ampuero

Dios

2010

Clinical Orthopaedics &Amp; Related Research

159

103

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Background Late infection is the second most frequent early complication after total hip arthroplasty (THA) and the most frequent after hemiarthroplasty. Known risk factors for infection after THA include posttraumatic osteoarthritis, previous surgery, chronic liver disease, corticoid therapy, and excessive surgical time. However, risk factors for hemiarthroplasty are not clearly established. Questions/purposes We therefore determined the preoperative and intraoperative risk factors for late infection (more than 3 months after surgery) in patients with hemiarthroplasties and THAs. Methods We retrospectively compared 47 patients with a hip arthroplasty (23 hemiarthroplasties, 24 total hip arthroplasties) and late infection with 200 randomlyselected patients with primary arthroplasty (100 hemiarthroplasties, 100 total hip arthroplasties) during the same time period of time without any infection during followup. Potential risk factors were identified from medical records. Minimum followup was 12 months (mean, 27 months; range, 12-112 months) for the study group and 18 months (mean, 84 months; range, 18-144 months) for the control group. Results The following factors were more frequent in late infected hemiarthroplasties: female gender; previous surgery; obesity (body mass index greater than 30 kg/m 2 ); glucocorticoid and immunosuppressant treatments; prolonged surgical time; inadequate antibiotic prophylaxis; prolonged wound drainage; hematoma; dislocation; and cutaneous, urinary, and/or abdominal infections. The following were more frequent in infected total hip arthroplasties: posttraumatic osteoarthritis; previous surgery; glucocorticoids; chronic liver disease; alcohol and intravenous drug abuse; prolonged surgical time; prolonged wound drainage; dislocation; subsequent surgery; and cutaneous, urinary, respiratory and abdominal infections. Diabetes did not appear to be a risk factor. Conclusions Our data suggest there are specific risk factors for infection in hemiarthroplasties.

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Appearance of septic hip prostheses on plain radiographs.

Cited by 122 publications

References 11 publications

Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy

Diagnosis of peri-prosthetic infection at the hip using triple-phase bone scintigraphy

Are Antibiotics Necessary in Hip Arthroplasty With Asymptomatic Bacteriuria? Seeding Risk With/Without Treatment

What Are the Risk Factors for Infection in Hemiarthroplasties and Total Hip Arthroplasties?

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