Tehranzadeh J, Schneider R, Freiberger R H
Radiology. 1981 Nov;141(2):355-62. doi: 10.1148/radiology.141.2.6457316.
Ninety-four cases of clinically failed, cemented, total hip prostheses requiring surgery were reviewed to determine the accuracy of preoperative plain radiography, culture of aspirated fluid, arthrography, and bone scanning. When radiopaque cement had been used to embed the prosthesis, plain radiography was highly accurate in detecting a loose femoral component, less so in detecting a loose acetabular component. Culture of aspirated fluid was accurate in diagnosing infection. A positive arthrogram identified loosening with good accuracy; however, a negative arthrogram did not reliably exclude loosening. 99mTc bone scans frequently differentiated loosening from loosening with infection. The suggested sequence of diagnostic tests is plain radiography followed by bone scanning. If the bone scan shows diffuse augmented uptake, culture of aspirated fluid followed by arthrography is indicated.
对94例临床失败且需手术的骨水泥型全髋关节假体病例进行回顾，以确定术前X线平片、抽吸液培养、关节造影和骨扫描的准确性。当使用不透射线的骨水泥固定假体时，X线平片在检测股骨部件松动方面准确性很高，而检测髋臼部件松动的准确性稍低。抽吸液培养在诊断感染方面较为准确。关节造影阳性对诊断松动具有较高的准确性；然而，关节造影阴性并不能可靠地排除松动。99mTc骨扫描常常能区分松动与感染性松动。建议的诊断检查顺序是先进行X线平片，然后是骨扫描。如果骨扫描显示弥漫性摄取增加，则应进行抽吸液培养，随后进行关节造影。
