Diagnostic protocol in prosthetic loosening.

The authors report the results they obtained in 35 cases studied based on a protocol to identify prosthetic loosening and to preoperatively establish its possible septic etiology. After clinical and radiographic assessment, the protocol called for a total body bone scan with Tc 99 m which, in positive cases, were associated laboratory tests and further instrumental testing (CT, bone scan and needle aspiration). Thanks above all to bone scan with labelled granulocytes the protocol provided high accuracy (91.4%) in preoperatively identifying the causes of infection.