The value of contrast arthrography in assessing loosening of symptomatic uncemented total hip components
Articles
- 29 Downloads
- 11 Citations
Abstract
Twenty-five patients with symptomatic uncemented total hip components were studied with contrast arthrography prior to surgical exploration. All but one had uncemented femoral stems and 16 had an uncemented acetabular component. As judged by the findings at surgery, on the femoral side the sensitivity, specificity, and accuracy of arthrography were 57%, 60%, and 58% respectively. There was a relatively high incidence of both false positives (17%) and false negatives (25%). On the acetabular side sensitivity, specificity, and accuracy were 29%, 89%, and 62.5%. False negatives were common (31%), while there was only one false positive. The results in this small series show that arthrography has distinct limitations in identifying the fixation status of uncemented total hip components.
Key words
Arthrography Uncemented loosening Total hip replacementPreview
Unable to display preview. Download preview PDF.
References
- 1.Bassett LW, Loftus AA, Markovitch NJ (1985) Computer-processed subtraction arthrography. Radiology 157:821Google Scholar
- 2.Callaghan JJ, Dysart SH, Savory CG (1988) The uncemented porous-coated anatomic total hip prosthesis. Two-year results of a prospective consecutive series. J Bone Joint Surg [Am] 70:337Google Scholar
- 3.Campbell ACL, Rorabeck CH, Bourne R, Chess DG, Nott L (1990) Thigh pain and the porous-coated anatomic total hip arthroplasty: annoyance or ill omen? Paper no. 211. Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans, February 1990Google Scholar
- 4.Cook SD, Barrack RL, Thomas KA, Haddad RJ Jr (1988) Quantitative analysis of tissue growth into human porous total hip components. J Arthroplasty 3:250Google Scholar
- 5.Cook SD, Barrack RL, Thomas KA, Haddad RJ Jr (1991) Tissue growth into porous primary and revision femoral stems. J Arthroplasty 6 (Suppl):S37–46Google Scholar
- 6.Drinker H, Turner RH, McKenzie JD, Bierbaum NE, Lawsing JF (1978) Color subtraction arthrography in the diagnosis of component loosening in hip arthroplasty. Orthopedics 1:223Google Scholar
- 7.Engh CA, Bobyn JD, Glassman H (1987) Porous-coated hip replacement in factors governing bone ingrowth, stress shielding and clinical results. J Bone Joint Surg [Br] 69:45Google Scholar
- 8.Haddad RJ Jr, Skalley TC, Cook SD, Brinker MR, Cheramie J, Meyer R, Missry J (1990) Clinical and roentgenographic evaluation of noncemented porous coated AML and PCA total hip arthroplasties. Clin Orthop 258:176Google Scholar
- 9.Hardy DC, Reinus WR, Totty WG, Keyser CK (1988) Arthrography after total hip arthroplasty: utility of postambulation radiographs. Skeletal Radiol 17:20Google Scholar
- 10.Harris WH, Mulroy RD Jr, Maloney WJ, Burke DW, Chandler HP, Zalenski EB (1991) Intraoperative measurement of rotational stability of femoral components of total hip arthroplasty. Clin Orthop 266:119Google Scholar
- 11.Hendrix RW, Wixson RL, Rana NA, Rogers LF (1983) Arthrography after total hip arthroplasty: a modified technique used in the diagnosis of pain. Radiology 148:647Google Scholar
- 12.Lyons CW, Berquist TH, Lyons JS, Rand JA, Brown ML (1985) Evaluation of radiographic findings in painful hip arthroplasties. Clin Orthop 195:239Google Scholar
- 13.Maus JP, Berquist TH, Bender CE, Rand JA (1987) Arthrographic study of painful total hip arthroplasty: refined criteria. Radiology 162:721Google Scholar
- 14.Murray WR, Rodrigo JJ (1975) Arthrography for the assessment of pain after total hip replacement. A comparison of arthrographic findings in patients with and without pain. J Bone Joint Surg [Am] 57:1060Google Scholar
- 15.O'Neill DA, Harris WH (1984) Failed total hip replacement: assessment by plain radiographs, arthrograms and aspiration of the joint. J Bone Joint Surg [Am] 66:540Google Scholar
- 16.Peroutka RM, McCollum DE, Nunley JA (1988) Uncemented primary porous coated anatomic total hip replacements: preliminary results. Presented at the Annual Meeting of the American Orthopaedic Association, Hot Springs, Virginia, June 1988Google Scholar
- 17.Petty RW, Fajgenbaum MD, Bush C (1988) Comparison of cemented and uncemented primary total hip arthroplasty. Presented at the Annual Meeting of the American Orthopaedic Association, Hot Springs, Virginia, June 1988Google Scholar
- 18.Salvati EA, Ghelman B, McLaren T, Wilson PD (1974) Subtraction technique in arthrography for loosening of total hip replacement fixed with radiopaque cement. Clin Orthop 101:105Google Scholar
- 19.Scott A, Cooper L, Pinczewski WK (1990) Evaluation of total hip arthroplasty loosening with combined radionuclide and contrast arthrograph. J Nucl Med 31:712Google Scholar
- 20.Serocki J, Dorr LD, Mackel A, Gruen T (1990) A comparison of cemented versus porous ingrowth hip arthroplasty in patients with bilateral hip replacements. Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans, February 1990Google Scholar
- 21.Swan JS, Braunstein EM, Wellman HN, Capello W (1991) Contrast and nuclear arthrography in loosening of the uncemented hip prosthesis. Skeletal Radiol 20:15Google Scholar
- 22.Vaughn BK, Mallory TH, Buchert PK, Lombardi AV Jr (1988) Porous coated anatomic cementless total hip replacement: clinical and roentgenographic results with minimum two-year follow-up. Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, Atlanta, February 1988Google Scholar
Copyright information
© International Skeletal Society 1994