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Arthroplasty Complication
Fathima Fijula P. Manzil, MD; Umesh D. Oza, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      TERMINOLOGY

      • Definitions

        • > 800,000 hip and knee joint arthroplasties performed in USA annually
          • Less frequently, shoulder, wrist, and elbow arthroplasties performed
        • Prosthesis made of metal (cobalt-chromium or titanium) and ultra high molecular-weight polyethylene material
        • Components attached to native bone with surgical cement (polymethylmethacrylate), application of hydroxyapatite compound to their surface, or by constructing prosthetic materials with porous coating to allow bone ingrowth
        • 10 years after implantation, 50% of prostheses show radiographic evidence of loosening and 30% require revision
          • Accuracy for diagnosing complications of lower extremity joint prostheses is 50-70%

      IMAGING

      • General Features

        • Radiographic Findings

          • Nuclear Medicine Findings

            • Imaging Recommendations

              DIFFERENTIAL DIAGNOSIS

                CLINICAL ISSUES

                • Presentation

                  • Treatment

                    DIAGNOSTIC CHECKLIST

                    • Consider

                      Selected References

                      1. Barnsley L et al: Detection of aseptic loosening in total knee replacements: a systematic review and meta-analysis. Skeletal Radiol. 48(10):1565-72, 2019
                      2. Blanc P et al: The use of labelled leucocyte scintigraphy to evaluate chronic periprosthetic joint infections: a retrospective multicentre study on 168 patients. Eur J Clin Microbiol Infect Dis. 38(9):1625-31, 2019
                      3. Palestro CJ: Nuclear medicine and the failed joint replacement: Past, present, and future. World J Radiol. 6(7):446-58, 2014
                      4. Osmon DR et al: Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 56(1):e1-e25, 2013
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Imaging

                        • Top Differential Diagnoses

                          TERMINOLOGY

                          • Definitions

                            • > 800,000 hip and knee joint arthroplasties performed in USA annually
                              • Less frequently, shoulder, wrist, and elbow arthroplasties performed
                            • Prosthesis made of metal (cobalt-chromium or titanium) and ultra high molecular-weight polyethylene material
                            • Components attached to native bone with surgical cement (polymethylmethacrylate), application of hydroxyapatite compound to their surface, or by constructing prosthetic materials with porous coating to allow bone ingrowth
                            • 10 years after implantation, 50% of prostheses show radiographic evidence of loosening and 30% require revision
                              • Accuracy for diagnosing complications of lower extremity joint prostheses is 50-70%

                          IMAGING

                          • General Features

                            • Radiographic Findings

                              • Nuclear Medicine Findings

                                • Imaging Recommendations

                                  DIFFERENTIAL DIAGNOSIS

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Barnsley L et al: Detection of aseptic loosening in total knee replacements: a systematic review and meta-analysis. Skeletal Radiol. 48(10):1565-72, 2019
                                          2. Blanc P et al: The use of labelled leucocyte scintigraphy to evaluate chronic periprosthetic joint infections: a retrospective multicentre study on 168 patients. Eur J Clin Microbiol Infect Dis. 38(9):1625-31, 2019
                                          3. Palestro CJ: Nuclear medicine and the failed joint replacement: Past, present, and future. World J Radiol. 6(7):446-58, 2014
                                          4. Osmon DR et al: Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 56(1):e1-e25, 2013