Abstract
Purpose
Total hip arthroplasty (THA) is a widespread option for treating hip osteoarthritis. Peri-prosthetic complications after THA represent a common event influencing patient outcome and costs. The purpose of this paper is to report the use of ultrasonography (US) to detect peri-prosthetic complications in symptomatic patients who underwent THA.
Methods
We retrospectively reviewed the records of patients with THA who underwent imaging evaluation between January 2009 and December 2012 at two different institutions. We evaluated the presence/absence of superficial and/or deep peri-prosthetic collections as well as the presence/absence of a cutaneous sinus tract. For patients who underwent both MRI and US, a concordance correlation analysis between US and MR findings was performed.
Results
In the reference period, 532 symptomatic patients (mean age ± standard deviation 74 ± 12 years) underwent X-ray and MRI examinations for suspected peri-prosthetic complications. Among them, 111 (20.9 %) underwent also US. Overall, 108 patients underwent both US and MRI. US findings included 67 superficial collections, 48 subcutaneous fistulas, 74 deep peri-prosthetic collections. Twenty-four patients had solid, mass-like peri-prosthetic collections. In 11 patients, no peri-prosthetic complications were seen. MRI findings included 68 superficial collections, 49 subcutaneous fistulas, 79 deep peri-prosthetic collections. Twenty-four patients had solid, mass-like peri-prosthetic collections. In four patients, no peri-prosthetic complications were seen. Concordance analysis between US and MRI findings showed almost perfect agreement (k ≥ 0.89).
Conclusion
US is an efficient and practical imaging modality to evaluate peri-prosthetic complications in patients with THA, being almost comparable to MRI in detecting and characterizing these complications.
Riassunto
Obiettivo
L’artroprotesi totale di anca (PTA) rappresenta una valida opzione per il trattamento della patologia osteoartrosica. L’incidenza di complicanze post-intervento è una problematica che influenza costi e risultato terapeutico. Scopo del lavoro è stato riportare la nostra esperienza nella valutazione ecografica di complicanze peri-protesiche in pazienti sottoposti a PTA.
Metodi
Abbiamo riesaminato retrospettivamente i referti di pazienti con sospetto di complicanze peri-protesiche che hanno eseguito follow up diagnostico presso due ospedali da Gennaio 2009 e Dicembre 2012. Abbiamo valutato la presenza/assenza di raccolte superficiali e/o profonde e la presenza di eventuali fistole cutanee. Per ogni paziente che ha eseguito risonanza magnetica (RM) ed ecografia abbiamo stimato la concordanza dei dati.
Risultati
In tale periodo, 532 pazienti (età media ± deviazione standard 74 ± 12 anni) hanno eseguito follow-up radiologico e RM presso gli istituti di riferimento. Centoundici pazienti (20.9 %) hanno anche effettuato ecografia. I pazienti che hanno eseguito ecografia e RM sono stati 108. I reperti ecografici includevano: 67 raccolte superficiali e 74 profonde, 48 fistole sottocutanee. Ventiquattro pazienti mostravano raccolte solide. Undici pazienti non mostravano complicanze. I reperti di risonanza magnetica includevano: 68 raccolte superficiali e 79 profonde, 49 fistole cutanee. Ventiquattro pazienti mostravano raccolte solide. Quattro pazienti non mostravano complicanze. L’analisi statistica dei dati ha dimostrato un’alta concordanza tra reperti ecografici e RM (k ≥ 0.89).
Conclusioni
l’ecografia è una modalità di imaging pratica ed efficace nel valutare pazienti sottoposti ad artoprotesi d’anca con sospetto di complicanze peri-protesiche, con alta correlazione con l’esame RM.
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Conflict of interest
Silvana Sdao, Davide Orlandi, Alberto Aliprandi, Francesca Lacelli, Luca Maria Sconfienza, Filippo Randelli, Francesco Sardanelli, Giovanni Serafini declare that they have no conflict of interest.
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All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Patients’ informed consent was waived for the present study.
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Sdao, S., Orlandi, D., Aliprandi, A. et al. The role of ultrasonography in the assessment of peri-prosthetic hip complications. J Ultrasound 18, 245–250 (2015). https://doi.org/10.1007/s40477-014-0107-4
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DOI: https://doi.org/10.1007/s40477-014-0107-4