Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, Pauwelsstraße 30, 52074, Aachen, Germany.
Department of Orthopaedic Surgery, University Hospital of Tübingen, 72076, Tübingen, Germany.
Eur J Med Res. 2024 Jun 8;29(1):314. doi: 10.1186/s40001-024-01891-8.
Conventional radiography is regularly used to evaluate complications after total hip arthroplasty. In various recent consensus meetings, however, plain radiographs of a potentially infected hip joint have been judged as being only relevant to exclude diagnoses other than infection. Solid data on radiographic presentations of periprosthetic joint infection (PJI) are scarce. As a result, the prognostic value of radiological features in low-grade PJI remains uncertain. The present review article aims to present an overview of the available literature and to develop ideas on future perspectives to define the diagnostic possibilities of radiography in PJIs of the hip. The primary outcome of interest of this systematic review was the radiologic presentation of periprosthetic joint infections of the hip. As secondary outcome of interest served the sensitivity and specificity of the radiologic presentation of periprosthetic joint infections. Of the included articles, 26 were reviews, essays, or case reports and only 18 were clinical studies. Typical radiologic abnormalities of PJI were a periosteal reaction, a wide band of radiolucency at the cement-bone or metal-bone interface, patchy osteolysis, implant loosening, bone resorption around the implant, and transcortical sinus tracts. The frequency of their occurrence is still inadequately defined. A deeper understanding of the underlying causes and the relation between microorganisms to radiologic abnormalities can probably help clinicians in the future to diagnose a PJI. This is why further research shall focus on the radiographic features of PJI.
常规放射学常用于评估全髋关节置换术后的并发症。然而，在最近的几次共识会议上，对于潜在感染的髋关节，普通 X 光片被认为仅与排除感染以外的诊断有关。有关假体周围关节感染 (PJI) 的放射学表现的可靠数据很少。因此，低级别 PJI 中放射学特征的预后价值仍不确定。本文旨在对现有文献进行综述，并为未来定义髋关节 PJI 放射学诊断可能性的观点提供思路。本系统评价的主要研究结果是髋关节假体周围关节感染的放射学表现。次要研究结果是假体周围关节感染的放射学表现的敏感性和特异性。纳入的文章中，有 26 篇是综述、论文或病例报告，只有 18 篇是临床研究。PJI 的典型放射学异常包括骨膜反应、骨水泥-骨或金属-骨界面处宽的透光带、斑片状溶骨、植入物松动、植入物周围骨吸收和皮质窦道。它们的发生频率仍未得到充分定义。对潜在原因和微生物与放射学异常之间关系的更深入了解，可能有助于临床医生在未来诊断 PJI。这就是为什么进一步的研究应集中在 PJI 的放射学特征上。
