Diagnostic value of bone scintigraphy for aseptic loosening after total knee arthroplasty

Abstract

BACKGROUND: Despite technical improvements, aseptic loosening after total knee arthroplasty (TKA) remains a frequent complication. A one-stage revision arthroplasty is the most common therapeutic pathway. OBJECTIVE: The aim of this study was to evaluate the diagnostic value of bone scintigraphy in detecting aseptic loosening after TKA. METHODS: We retrospectively identified 46 cases of one-stage revision TKA performed between January 2011 and December 2012. In each case a bone scintigraphy was performed at least one year after the primary TKA and 3.2 ± 2.2 month prior to revision arthroplasty. Additionally, we evaluated the rate of satisfaction and pain level 16.2 ± 5.4 months after one-stage revision arthroplasty. RESULTS: Bone scintigraphy indicated aseptic loosening in 28 cases. Intraoperative aseptic loosening was verified in 34 cases. Bone scintigraphy had a sensitivity of 0.76 and a specificity of 0.83 in detecting aseptic loosening. The positive predictive value was 0.93, and the negative predictive value 0.56. At follow-up consultation, 35 patients were very satisfied or satisfied, and 31 patients had no pain or occasional pain. CONCLUSIONS: Bone scintigraphy is a helpful tool in detecting aseptic loosening after TKA. Nevertheless, the results from bone scintigraphy should be compared with clinical findings and patients' disorders. Level of evidence: IV, retrospective study

Diagnostic Accuracy Of Spect/CT Arthrography In Patients With Suspected Aseptic Joint Prostheses Loosening

“…A meta-analysis by Temmerman et al reported a pooled sensitivity and speci city for plain radiography of 82% and 81%, respectively 15 . The most recent study on bone scintigraphy by Claassen et al reported a sensitivity of 76% and a speci city of 83% 16 . Interestingly, planar nuclear arthrography on its own has a low reported sensitivity and speci city of 87% and 64% [15].…”

Diagnostic Accuracy of SPECT/CT Arthrography in Patients With Suspected Aseptic Joint Prosthesis Loosening

“…A meta-analysis by Temmerman et al reported a pooled sensitivity and speci city for plain radiography of 82% and 81%, respectively 15 . The most recent study on bone scintigraphy by Claassen et al reported a sensitivity of 76% and a speci city of 83% 16 . Interestingly, planar nuclear arthrography on its own has a low reported sensitivity and speci city of 87% and 64% [15].…”

Diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic joint prostheses loosening

“…A meta-analysis by Temmerman et al reported a pooled sensitivity and specificity for plain radiography of 82% and 81%, respectively (Temmerman et al 2005). The most recent study on bone scintigraphy by Claassen et al reported a sensitivity of 76% and a specificity of 83% (Claassen et al 2014). Interestingly, planar nuclear arthrography on its own has a low reported sensitivity and specificity of 87% and 64% (Temmerman et al 2005).…”

“…The most recent study on bone scintigraphy by Claassen et al . reported a sensitivity of 76% and a specificity of 83% (Claassen et al 2014 ). Interestingly, planar nuclear arthrography on its own has a low reported sensitivity and specificity of 87% and 64% (Temmerman et al 2005 ).…”