The value of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip prostheses: A meta-analysis

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• 作者：Olivier P.P. Temmerman ; Ide C. Heyligers ; Gerrit J.J. Teule ; Otto S. Hoekstra and Pieter G.H.M. Raijmakers
• 刊名：European Journal of Radiology
• 出版年：2005
• 出版时间：2005
• 年：2005
• 卷：56
• 期：1
• 页码：113-119
• 全文大小：174 K

文摘

class=""h4"">Objective:

To summarize and compare the diagnostic accuracy of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip arthroplasties.

class=""h4"">Design:

This meta-analysis was performed using methods described by the Cochrane Methods Group on Systematic Reviews of Screening and Diagnostic Tests. We included original, English-language papers published between January 1975 to October 2004 that examined contrast-enhanced arthrography with or without subtraction for diagnosis of loosening of total hip prostheses. A qualitative and quantitative analysis was performed by two investigators.

class=""h4"">Results:

With regard to the acetabular component, pooled sensitivity and specificity for contrast arthrography was 70 % (95 % confidence interval, 52–84) and 74 % (95 % CI, 53–87), respectively. Subtraction arthrography had a significantly higher sensitivity of 89 % (95 % CI, 84–93) (p = 0.01), with a similar specificity of 76 % (95 % CI, 68-82). For the femoral component, pooled sensitivity and specificity for contrast arthrography were 63 % (95 % CI, 53–72) and 78 % (95 % CI, 68–86). Pooled estimates for subtraction arthrography revealed a significantly higher sensitivity of 86 % (95 % CI, 74–93) (p = 0.003). Specificity was 85 % (95 % CI, 77–91) and was similar to the data of contrast arthrography (p = 0.23).

class=""h4"">Conclusion:

Using the present data we found that the subtraction arthrography is a sensitive technique for detection of loosening of total hip prostheses, offering added value over contrast arthrography, especially for evaluation of the femoral component.