The role of MRI in the diagnosis of aseptic loosening following total hip arthroplasty.

IF 2 3区医学 Q2 ORTHOPEDICS

Archives of Orthopaedic and Trauma Surgery Pub Date : 2024-09-24 DOI:10.1007/s00402-024-05592-z

Itay Ashkenazi, Akram Habibi, Sophia Jacobi, Vinay K Aggarwal, Ran Schwarzkopf, Joshua C Rozell

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引用次数: 0

Abstract

Introduction: The role of advanced imaging in diagnosing aseptic implant loosening following total hip arthroplasty (THA) remains unclear. This study aimed to assess the diagnostic value of magnetic resonance imaging (MRI) in detecting aseptic loosening.

Methods: This was a retrospective review of 342 consecutive patients who underwent revision THA between July 2011 and April 2023 and had a pelvis MRI as part of the preoperative diagnostic evaluation. Among them, 62 patients had an intraoperative diagnosis of aseptic loosening of either the femoral or acetabular component. Patients were stratified based on the concordance between their MRI and radiographs findings.

Results: Preoperative MRI showed signs of aseptic loosening in 25/62 patients (sensitivity = 40.3%). Similarly, preoperative radiographs demonstrated signs of aseptic loosening in 27 patients (43.5%). Twelve patients (19.4%) had both MRI and radiographs predictive of aseptic loosening, 22 patients (35.5%) did not show signs of aseptic loosening in either MRI or radiographs, and for 28 patients (45.2%), the results were discordant. Among the patients with a negative radiograph for aseptic loosening (n = 35), 13 patients (37.1%) showed signs of aseptic loosening on MRI.

Conclusion: Aseptic loosening remains an elusive diagnosis, and the findings of this study suggest that the utility of MRI and radiographs as part of the diagnostic process is limited. However, in cases of presumed aseptic loosening with inconclusive radiographs findings, MRI may play a role in improving the diagnostic process.

Level of evidence: III.

查看原文本刊更多论文

核磁共振成像在诊断全髋关节置换术后无菌性松动中的作用。

导言：先进的成像技术在诊断全髋关节置换术（THA）后无菌植入物松动方面的作用仍不明确。本研究旨在评估磁共振成像（MRI）在检测无菌性松动方面的诊断价值：本研究对 2011 年 7 月至 2023 年 4 月间接受翻修髋关节置换术的 342 例连续患者进行了回顾性研究，骨盆磁共振成像是术前诊断评估的一部分。其中 62 例患者术中诊断为股骨或髋臼组件无菌性松动。根据核磁共振成像和X光片结果的一致性对患者进行了分层：结果：术前核磁共振成像显示，25/62 例患者出现无菌性松动迹象（敏感性= 40.3%）。同样，27 名患者（43.5%）的术前 X 光片也显示出无菌性松动的迹象。12名患者（19.4%）的核磁共振成像和X光片均可预测无菌性松动，22名患者（35.5%）的核磁共振成像和X光片均未显示无菌性松动的迹象，28名患者（45.2%）的结果不一致。在X光片显示无菌性松动呈阴性的患者（35人）中，有13人（37.1%）在核磁共振成像中显示出无菌性松动的迹象：结论：无菌性松动仍然是一种难以诊断的疾病，本研究结果表明，核磁共振成像和X光片作为诊断过程的一部分，其作用是有限的。然而，在推测为无菌性松动但放射线检查结果不确定的病例中，核磁共振成像可在改善诊断过程中发挥作用：证据等级：III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).