Ovesen Ole, Riegels-Nielsen Per, Lindequist Sten, Jensen Ib, Munkner Troels, Torfing Trine, Marving Jens
Department of Orthopedics, Odense University Hospital, Denmark.
J Arthroplasty. 2003 Sep;18(6):735-40. doi: 10.1016/s0883-5403(03)00108-6.
A prospective analysis of plain serial radigraphs (PSR), digital subtraction arthrography (DSA), and radionuclide bone scans (RBS) was performed in 56 cemented total hip arthroplasties to evaluate the efficacy and usefulness of each study in the diagnosis of loosening. To avoid selection bias in the evaluation of DSA and RBS, the decision to perform repeat surgery was based exclusively on the clinical history and PSR. Results of each study were compared with intraoperative assessment of the status of components and expressed in terms of sensitivity, specificity, and accuracy. Overall accuracy for the acetabular component by PSR was 66%; by DSA, 93%; by RBS, 46%. Overall accuracy for the femoral component by PSR was 79%; by DSA, 93%; RBS, 50%. Our results indicate that DSA can be recommended as a further analysis in cases with a painful hip prosthesis and no or inconclusive findings on PSR. RBS did not give any useful information and cannot be recommended routinely.
对56例骨水泥型全髋关节置换术患者进行了普通系列X线片（PSR）、数字减影关节造影（DSA）和放射性核素骨扫描（RBS）的前瞻性分析，以评估每项检查在诊断假体松动方面的有效性和实用性。为避免在DSA和RBS评估中出现选择偏倚，再次手术的决定完全基于临床病史和PSR。将每项检查的结果与术中对假体部件状态的评估进行比较，并以敏感性、特异性和准确性表示。PSR对髋臼部件的总体准确率为66%；DSA为93%；RBS为46%。PSR对股骨部件的总体准确率为79%；DSA为93%；RBS为50%。我们的结果表明，对于髋关节假体疼痛且PSR无异常或结果不明确的病例，可推荐DSA作为进一步的分析方法。RBS未提供任何有用信息，不建议常规使用。
