Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/106351
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: The diagnostic performance of radiographic criteria to detect aseptic acetabular component loosening after revision total hip arthroplasty
Author: Abrahams, J.
Kim, Y.
Callary, S.
De Ieso, C.
Costi, K.
Howie, D.
Solomon, L.
Citation: Bone and Joint Journal, 2017; 99B(4):458-464
Publisher: British Editorial Society of Bone and Joint Surgery
Issue Date: 2017
ISSN: 2049-4394
2049-4408
Statement of
Responsibility: 
J. M. Abrahams, Y. S. Kim, S. A. Callary, C. De Ieso, K. Costi, D. W. Howie, L. B. Solomon
Abstract: Aims: This study aimed to determine the diagnostic performance of radiographic criteria to detect aseptic acetabular loosening after revision total hip arthroplasty (THA). Secondary aims were to determine the predictive values of different thresholds of migration and to determine the predictive values of radiolucency criteria. Patients and Methods: Acetabular component migration to re-revision was measured retrospectively using Ein- Bild-Rontgen-Analyse (EBRA-Cup) and manual measurements (Sutherland method) in two groups: Group A, 52 components (48 patients) found not loose at re-revision and Group B, 42 components (36 patients) found loose at re-revision between 1980 and 2015. The presence and extent of radiolucent lines was also assessed. Results: Using EBRA, both proximal translation and sagittal rotation were excellent diagnostic tests for detecting aseptic loosening. The area under the receiver operating characteristic (ROC) curves was 0.94 and 0.93, respectively. The thresholds of 2.5 mm proximal translation or 2° sagittal rotation (EBRA) in combination with radiolucency criteria had a sensitivity of 93% and specificity of 88% to detect aseptic loosening. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of radiolucency criteria were 41%, 100%, 100% and 68% respectively. Manual measurements of both proximal translation and sagittal rotation were very good diagnostic tests. The area under the ROC curve was 0.86 and 0.92 respectively. However, manual measurements had a decreased specificity compared with EBRA. Radiolucency criteria had a poor sensitivity and NPV of 41% and 68% respectively. Conclusion: This study shows that EBRA and manual migration measurements can be used as accurate diagnostic tools to detect aseptic loosening of cementless acetabular components used at revision THA. Radiolucency criteria should not be used in isolation to exclude loosening of cementless acetabular components used at revision THA given their poor sensitivity and NPV.
Keywords: Acetabulum
Rights: ©2017 The British Editorial Society of Bone & Joint Surgery
RMID: 0030067629
DOI: 10.1302/0301-620X.99B4.BJJ-2016-0804.R1
Appears in Collections:Orthopaedics and Trauma publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.