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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 6, 781-785.
doi: 10.1302/0301-620X.87B6.15625  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Accuracy of diagnostic imaging techniques in the diagnosis of aseptic loosening of the femoral component of a hip prosthesis

A META-ANALYSIS

O. P. P. Temmerman, MD, Research Fellow1; P. G. H. M. Raijmakers, MD, PhD, Nuclear Medicine Physician1; J. Berkhof, PhD, Statistician2; O. S. Hoekstra, MD, PhD, Nuclear Medicine Physician1; G. J. J. Teule, MD, PhD, Nuclear Medicine Physician, Professor1; and I. C. Heyligers, MD, PhD, Orthopaedic Surgeon3

1 Department of Nuclear Medicine
2 Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Boelalaan 1117, 1007 MB Amsterdam, The Netherlands.
3 Department of Orthopaedic Surgery, Atrium Medical Centre, Henri Dunanstraat 5, 6401CX Heerlen, The Netherlands.

Correspondence should be sent to Dr O. P. P. Temmerman; e-mail: opp.temmerman{at}vumc.nl

In this meta-analysis we included 32 English-language articles published between January 1975 and June 2004 on the diagnostic performance of plain radiography, subtraction arthrography, nuclear arthrography and bone scintigraphy in detecting aseptic loosening of the femoral component, using criteria based on the Cochrane systematic review of screening and diagnostic tests.

The mean sensitivity and specificity were, respectively, 82% (95% confidence interval (CI) 76 to 87) and 81% (95% CI 73 to 87) for plain radiography and 85% (95% CI 75 to 91) and 83% (95% CI 75 to 89) for nuclear arthrography. Pooled sensitivity and specificity were, respectively, 86% (95% CI 74 to 93) and 85% (95% CI 77 to 91) for subtraction arthrography and 85% (95% CI 79 to 89) and 72% (95% CI 64 to 79) for bone scintigraphy. Although the diagnostic performance of the imaging techniques was not significantly different, plain radiography and bone scintigraphy are preferred for the assessment of a femoral component because of their efficacy and lower risk of patient morbidity.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General