Inducible displacement CT increases the diagnostic accuracy of aseptic loosening in primary total hip arthroplasty.
Background and purpose -- Inducible displacement CT compares 2 CTs acquired in series but with alternated rotation of the femur. This provides visual and quantitative clues as to the mechanical situation, i.e., loosening, of a total hip arthroplasty. We report the accuracy of this method as well as...
| Publicado en: | Acta Orthopaedica Vol. 93; pp. 831 - 837 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
2022
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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=162614188&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162614188 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2022 vid: 93 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 162614188 162614188 162614188 10.2340/17453674.2022.5240 162614188 ppf: 831 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Inducible displacement CT increases the diagnostic accuracy of aseptic loosening in primary total hip arthroplasty. aug: au: SANDBERG, Olof CARLSSON, Sofia HARBOM, Ellen CAPPELEN, Vendela THOLÉN, Simon OLIVECRONA, Henrik WRETENBERG, Per affil: Medicine and Surgery, Karolinska Institutet, Sweden sug: subj: Arthroplasty, Replacement, Hip Joint Prosthesis Adverse Effects Prosthesis Failure Diagnosis Tomography, X-Ray Computed Prosthesis Failure Radiography Human Retrospective Design Comparative Studies After Care Questionnaires Reoperation Sensitivity and Specificity Confidence Intervals Odds Ratio Descriptive Statistics ab: Background and purpose -- Inducible displacement CT compares 2 CTs acquired in series but with alternated rotation of the femur. This provides visual and quantitative clues as to the mechanical situation, i.e., loosening, of a total hip arthroplasty. We report the accuracy of this method as well as the experience of integrating it into a clinical workflow. Patients and methods -- This was a retrospective single centre study of 72 cases of suspected aseptic loosening were the surgeon after reviewing a standard plain radiograph saw a need for more information. The displacement CT and plain radiograph were compared either to intraoperative findings or a 1--3 year follow up questionnaire for patients that did not have revision surgery. Patients reporting degradation in status since the time of the displacement CT were called for a follow up plain radiograph. Sensitivity and specificity were assessed, and user experience gathered. Results -- Of 72 enrolled patients 15 were lost to followup. Of the remaining 57, 17 were judged by in-traoperative findings or follow-up to have had loose implants. For plain radiography the sensitivity and specificity were 59% (95% CI 35--82) and 85% (74--96). For displacement CT the corresponding values were 77% (56--97), and 100% (100--100) respectively. The tool was adaptable to clinical routine. Conclusion -- Displacement CT with alternated rotations of the femur is a viable option to improve the diagnostic process for identifying aseptic loosening in a total hip arthroplasty. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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