Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis : A meta-analysis

• Published in: Journal of bone and joint surgery. British volume Vol. 87; no. 6; pp. 781 - 785
• Main Authors: TEMMERMAN, O. P. P, RAIJMAKERS, P. G. H. M, BERKHOF, J, HOEKSTRA, O. S, TEULE, G. J. J, HEYLIGERS, I. C
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.06.2005; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Arthrography - methods; Arthroplasty, Replacement, Hip; Biological and medical sciences; Diseases of the osteoarticular system; Hip Joint - diagnostic imaging; Humans; Medical sciences; Orthopedic surgery; Prosthesis Failure; Radionuclide Imaging; ROC Curve; Sensitivity and Specificity; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Femur; Accuracy; Orthopedic surgery; Treatment; Prosthesis; Loosening; Orthopedics; Rheumatology; Diagnosis; Technique; Hip
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.87B6.15625

In this meta-analysis we included 32 English-language articles published between January 1975 and June 2004 on the diagnostic performance of plain radiography, subtraction arthrography, nuclear arthrography and bone scintigraphy in detecting aseptic loosening of the femoral component, using criteria based on the Cochrane systematic review of screening and diagnostic tests. The mean sensitivity and specificity were, respectively, 82% (95% confidence interval (CI) 76 to 87) and 81% (95% CI 73 to 87) for plain radiography and 85% (95% CI 75 to 91) and 83% (95% CI 75 to 89) for nuclear arthrography. Pooled sensitivity and specificity were, respectively, 86% (95% CI 74 to 93) and 85% (95% CI 77 to 91) for subtraction arthrography and 85% (95% CI 79 to 89) and 72% (95% CI 64 to 79) for bone scintigraphy. Although the diagnostic performance of the imaging techniques was not significantly different, plain radiography and bone scintigraphy are preferred for the assessment of a femoral component because of their efficacy and lower risk of patient morbidity.