Tigges S, Roberson J R, Cohen D E
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
Radiology. 1995 Jan;194(1):73-5. doi: 10.1148/radiology.194.1.7997585.
To determine whether findings on plain radiographs alter clinical care in outpatient management after hip arthroplasty.
From June 1, 1993, through February 28, 1994, one arthroplasty surgeon saw 148 outpatients (age range, 15-86 years) after hip arthroplasty (163 prostheses). The surgeon made decisions about clinical management before he reviewed the plain hip radiographs. After he reviewed the radiographs, he recorded any changes in the management plan.
In only one case did the radiographic findings change patient treatment. The prosthesis in this relatively asymptomatic patient had been in place for over 9 years and appeared clinically to be functioning well, but radiographs demonstrated aggressive granulomatosis. Therefore, the patient underwent revision arthroplasty. In the remaining 147 patients, radiographic findings had no impact on clinical management.
Radiographic evaluation may be most beneficial in patients with hip prostheses that have been in place for many years to rule out asymptomatic bone loss due to aggressive granulomatosis.
确定髋关节置换术后门诊管理中,X线平片检查结果是否会改变临床治疗方案。
1993年6月1日至1994年2月28日,一位关节置换外科医生诊治了148例髋关节置换术后门诊患者(年龄范围15 - 86岁,共163个假体)。该医生在查看髋关节X线平片之前做出临床管理决策,查看平片后记录管理计划的任何变化。
仅1例患者的X线检查结果改变了治疗方案。该相对无症状患者的假体已植入9年多,临床功能良好,但X线片显示有侵袭性肉芽肿。因此,该患者接受了翻修关节置换术。其余147例患者中,X线检查结果对临床管理无影响。
对于使用多年的髋关节假体患者,X线评估可能最有助于排除因侵袭性肉芽肿导致的无症状骨质流失。