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Article type: Research Article
Authors: Claassen, Leif; * | Ettinger, Max | Plaass, Christian | Daniilidis, Kiriakos | Calliess, Tilman | Ezechieli, Marco
Affiliations: Orthopedic Department, Hannover Medical School, Hannover, Germany
Correspondence: [*] Corresponding author: Leif Claassen, Orthopedic Department, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Tel.: +49 511 5354 534; Fax: +49 511 5354 134; E-mail: [email protected].
Abstract: Background:Despite technical improvements, aseptic loosening after total knee arthroplasty (TKA) remains a frequent complication. A one-stage revision arthroplasty is the most common therapeutic pathway. Objective:The aim of this study was to evaluate the diagnostic value of bone scintigraphy in detecting aseptic loosening after TKA. Methods:We retrospectively identified 46 cases of one-stage revision TKA performed between January 2011 and December 2012. In each case a bone scintigraphy was performed at least one year after the primary TKA and 3.2 ± 2.2 month prior to revision arthroplasty. Additionally, we evaluated the rate of satisfaction and pain level 16.2 ± 5.4 months after one-stage revision arthroplasty. Results:Bone scintigraphy indicated aseptic loosening in 28 cases. Intraoperative aseptic loosening was verified in 34 cases. Bone scintigraphy had a sensitivity of 0.76 and a specificity of 0.83 in detecting aseptic loosening. The positive predictive value was 0.93, and the negative predictive value 0.56. At follow-up consultation, 35 patients were very satisfied or satisfied, and 31 patients had no pain or occasional pain. Conclusions:Bone scintigraphy is a helpful tool in detecting aseptic loosening after TKA. Nevertheless, the results from bone scintigraphy should be compared with clinical findings and patients' disorders.
Keywords: Aseptic loosening, one-stage revision arthroplasty, total knee arthroplasty
DOI: 10.3233/THC-140850
Journal: Technology and Health Care, vol. 22, no. 5, pp. 767-773, 2014
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