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...

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Publicado en:Acta Orthopaedica Vol. 93; pp. 831 - 837
Autores principales: SANDBERG, Olof, CARLSSON, Sofia, HARBOM, Ellen, CAPPELEN, Vendela, THOLÉN, Simon, OLIVECRONA, Henrik, WRETENBERG, Per
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Medical Journals Sweden AB 2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2022
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      pub: Medical Journals Sweden AB
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        10.2340/17453674.2022.5240
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        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
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