TY - JOUR
T1 - The value of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip prostheses
T2 - a meta-analysis
AU - Temmerman, Olivier P P
AU - Heyligers, Ide C
AU - Teule, Gerrit J J
AU - Hoekstra, Otto S
AU - Raijmakers, Pieter G H M
PY - 2005/10
Y1 - 2005/10
N2 - OBJECTIVE: To summarize and compare the diagnostic accuracy of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip arthroplasties.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.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).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.
AB - OBJECTIVE: To summarize and compare the diagnostic accuracy of contrast and subtraction arthrography in the assessment of aseptic loosening of total hip arthroplasties.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.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).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.
KW - Adult
KW - Arthrography/methods
KW - Arthroplasty, Replacement, Hip/adverse effects
KW - Contrast Media/administration & dosage
KW - Hip Joint/diagnostic imaging
KW - Hip Prosthesis
KW - Humans
KW - Prosthesis Failure
KW - ROC Curve
KW - Radiographic Image Enhancement/methods
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Subtraction Technique
KW - Systematic literature review
KW - meta analysis (topic)
U2 - 10.1016/j.ejrad.2005.02.008
DO - 10.1016/j.ejrad.2005.02.008
M3 - Article
C2 - 15893898
VL - 56
SP - 113
EP - 119
JO - European Journal of Radiology
JF - European Journal of Radiology
SN - 0720-048X
IS - 1
ER -