title: The diagnostic value of digital subtraction arthrography and radionuclide arthrography in revision total hip arthroplasty.
abstract: An analysis of plain radiographs, digital subtraction arthrography, and radionuclide arthrography was performed in 25 revision hip arthroplasties to evaluate the efficacy and usefulness of these methods in the diagnosis of loosening. The findings by each method were compared with intraoperative assessment of the status of components and expressed in terms of sensitivity, specificity, and predictive accuracy. Overall accuracy for the acetabular component by plain radiographs was 80%; by digital subtraction arthrography, 88%; by radionuclide arthrography, 68%. Overall accuracy for the femoral component by plain radiographs was 92%; by digital subtraction arthrography, 84%; radionuclide arthrography, 76%. We consider subtraction arthrography and radionuclide arthrography to be adjuvant diagnostic tools which may be indicated in individual cases of suspected implant loosening of total hip arthroplasty. The routine use of these two methods is not warranted when compared to plain radiographs.
authors.affiliation: Department of Orthopaedic Surgery, University of Duisburg-Essen, Essen, Germany. mariusvonknoch@yahoo.com
authors.forename: Marius
authors.initials: M
authors.lastname: von Knoch
authors.forename: Bertram
authors.initials: B
authors.lastname: Barden
authors.forename: Guido
authors.initials: G
authors.lastname: Saxler
authors.forename: Franz
authors.initials: F
authors.lastname: Löer
mesh_terms: D001175:Arthrography / Q000379:methods*; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D011475:Prosthesis Failure; D011856:Radiographic Image Enhancement / Q000379:methods*; D011877:Radionuclide Imaging; D012086:Reoperation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D016896:Treatment Outcome