Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis. A meta-analysis. J Bone Joint Surg 87-B:781-785

VU University Amsterdam, Amsterdamo, North Holland, Netherlands
The Bone & Joint Journal (Impact Factor: 3.31). 07/2005; 87(6):781-5. DOI: 10.1302/0301-620X.87B6.15625
Source: PubMed


In this meta-analysis we included 32 English-language articles published between January 1975 and June 2004 on the diagnostic performance of plain radiography, subtraction arthrography, nuclear arthrography and bone scintigraphy in detecting aseptic loosening of the femoral component, using criteria based on the Cochrane systematic review of screening and diagnostic tests. The mean sensitivity and specificity were, respectively, 82% (95% confidence interval (CI) 76 to 87) and 81% (95% CI 73 to 87) for plain radiography and 85% (95% CI 75 to 91) and 83% (95% CI 75 to 89) for nuclear arthrography. Pooled sensitivity and specificity were, respectively, 86% (95% CI 74 to 93) and 85% (95% CI 77 to 91) for subtraction arthrography and 85% (95% CI 79 to 89) and 72% (95% CI 64 to 79) for bone scintigraphy. Although the diagnostic performance of the imaging techniques was not significantly different, plain radiography and bone scintigraphy are preferred for the assessment of a femoral component because of their efficacy and lower risk of patient morbidity.

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    • "Additionally nuclear arthrography had a high interobserver agreement [17]. In a meta-analysis by Temmermann et al., bone scintigraphy was reported to be less accurate A U T H O R C O P Y in detecting aseptic loosening after total hip arthroplasty compared to plain radiographs and subtraction arthrography [25]. Contrastingly, the same study group described good interobserver reliability with bone scintigraphy compared to plain radiographs [17]. "
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    ABSTRACT: 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.
    Technology and health care: official journal of the European Society for Engineering and Medicine 08/2014; 22(5). DOI:10.3233/THC-140850 · 0.70 Impact Factor
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    • "Studies were eligible for review if they met the following standardised inclusion criteria [20–22]: Full-length articles; studies including CSX or patients with angina and normal coronary arteries; minimum number of 10 patients; studies presenting follow-up data of more than 2 years; and publication dates between April 1985 and February 2010. "
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    Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 02/2012; 20(9):365-71. DOI:10.1007/s12471-012-0256-z · 1.84 Impact Factor
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    • "Diagnostic tools for detection of aseptic loosening are despite clinical evaluation the use of images like routine radiography, subtraction arthrography, nuclear arthrography and bone-scintigraphy [14-17,24,27,29,30,38]. Although these examination tools are extensively described in literature, at present time there is no diagnostic method reliable enough to analyse the cement mantel interface and the bone integrity of a THA months or years after the replacement [1,2,4-6,13,21,24,27,29,34,36]. "
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    ABSTRACT: At present there are no reliable non-traumatic and non- invasive methods to analyse the healing process and loosening status after total hip replacement. Therefore early as well as late loosening of prosthesis and interface component problems are difficult to be found or diagnosed at any time. In a cadaver study the potential application of Resonance Frequency Monitoring (RFM) will be evaluated as a non-invasive and non-traumatic method to monitor loosening and interface problems in hip replacement. In a 65 year old female cadaver different stability scenarios for a total hip replacement (shaft, head/modular head and cup, ESKA, Luebeck, Germany) are simulated in cemented and cement less prosthesis and then analysed with RFM. The types of stability vary from secure/press-fit to interface-shaft disruption. The RFM shows in cemented as well as cement less prosthesis significant intra-individual differences in the spectral measurements with a high dynamic (20 dB difference corresponding to the factor 100 (10000%)), regarding the simulated status of stability in the prosthesis system. The results of the study demonstrate RFM as a highly sensitive non-invasive and non-traumatic method to support the application of RFM as a hip prosthesis monitoring procedure. The data obtained shows the possibility to use RFM for osteointegration surveillance and early detection of interface problems, but will require further evaluation in clinical and experimental studies.
    European journal of medical research 07/2009; 14(6):264-71. DOI:10.1186/2047-783X-14-6-264 · 1.50 Impact Factor
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