Value of multidetector computed tomography for the differentiation of delayed aseptic and septic complications after total hip arthroplasty.
Objective: The differentiation between delayed aseptic and septic complications of total hip arthroplasty is crucial to allow appropriate surgical planning and timely antimicrobial treatment. The aim of this study was to investigate the utility of multidetector computed tomography (CT) findings to d...
| Publicado en: | Skeletal Radiology Vol. 49; no. 6; pp. 893 - 903 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jun2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142815881&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142815881 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03642348 O14 jtl: Skeletal Radiology issn: 03642348 maglogo: N pubinfo: dt: Jun2020 vid: 49 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 142815881 142815881 NLM31900512 10.1007/s00256-019-03355-1 NLM31900512 142815881 ppf: 893 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Value of multidetector computed tomography for the differentiation of delayed aseptic and septic complications after total hip arthroplasty. aug: au: Isern-Kebschull, Jaime Tomas, Xavier García-Díez, Ana Isabel Morata, Laura Moya, Ignacio Ríos, José Soriano, Alex affil: Department of Radiology, Hospital Clinic, University of Barcelona, C/ Villarroel 170, 08036, Barcelona, Spain sug: subj: Prosthesis Failure Arthritis, Infectious Multidetector Computed Tomography Methods Arthroplasty, Replacement, Hip Prosthesis-Related Infections Adult Middle Age Arthritis, Infectious Microbiology Diagnosis, Differential Male Pain Measurement Aged, 80 and Over Prosthesis-Related Infections Microbiology Retrospective Design Aged Risk Factors Reoperation Female Scales Adult: 19-44 years Middle Aged: 45-64 years Aged, 80 & over Aged: 65+ years Male Female ab: Objective: The differentiation between delayed aseptic and septic complications of total hip arthroplasty is crucial to allow appropriate surgical planning and timely antimicrobial treatment. The aim of this study was to investigate the utility of multidetector computed tomography (CT) findings to diagnose aseptic mechanical loosening, granulomatous reaction, and periprosthetic joint infection in patients who underwent total hip arthroplasty before revision surgery.Materials and Methods: Ninety-six consecutive patients with a clinical suspicion of periprosthetic complications underwent revision surgery over an 8-year period. All patients had been evaluated preoperatively using multidetector CT without contrast media. Two blinded musculoskeletal radiologists reviewed multidetector CT images, including periprosthetic soft-tissue accumulation, prosthetic acetabular malposition, periprosthetic osteolysis, enlarged iliac lymph nodes, and heterotopic ossification. Risk factors for aseptic and septic loosening were identified using multivariate analysis.Results: Multidetector CT-related variables independently associated with periprosthetic joint infection were high periprosthetic soft-tissue accumulation, periprosthetic osteolysis without expansile periosteal reaction and enlarged iliac lymph nodes. On the other hand, the absence of the following radiological signs: low or high periprosthetic soft-tissue accumulation, mild or severe periprosthetic osteolysis, and enlarged iliac lymph nodes, were predictors of aseptic mechanical loosening. Low periprosthetic soft-tissue accumulation, severe periprosthetic osteolysis with expansile periosteal reaction, and mild acetabular malposition were significant variables associated with granulomatosis.Conclusion: Multidetector CT findings are useful to differentiate between aseptic and septic complications before revision surgery. The presence of osteolysis with expansile periosteal reaction appeared to be a time-dependent variable. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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