Lara Barnsley1, Les Barnsley2,3. 1. Orthopaedic Department, Western Health, 160 Gordon Street, Footscray, Victoria, 3011, Australia. larabarnsley@gmail.com. 2. Department of Medicine, University of Sydney, Sydney, Australia. 3. Department of Rheumatology, Concord Hospital, Hospital Rd, Concord, NSW, 2139, Australia.
Abstract
OBJECTIVE: The aim of this study was to compare the diagnostic accuracy of nuclear imaging modalities in the detection of aseptic loosening of total knee arthroplasty (TKA). MATERIALS AND METHODS: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched from database inception to December 2018 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies compared the results of a single imaging modality against an appropriate reference standard of prosthetic TKA loosening, with sufficient information to determine either sensitivity and/or specificity. The methodological quality of the studies was assessed using the QUADAS-2 tool. RESULTS: The search strategy identified 572 abstracts. Of these, 12 studies comprising 401 patients across four modalities (bone scintigraphy, 18F-FDG-PET, SPECT/CT arthrogram, radionuclide arthrogram) met the inclusion criteria. All included studies used operative findings, a period of clinical or radiographic observation or both as a reference standard for aseptic loosening. Sixteen comparisons with the reference standards were extracted. All studies were at risk of bias across patient selection, the index test, reference standard, and flow and timing of patients. The most accurate test for diagnosis of aseptic loosening in TKA was SPECT/CT arthrography demonstrated by the summary receiver operating characteristic curve. CONCLUSIONS: The best available evidence suggests the most accurate modality for the detection of aseptic loosening in TKA is SPECT/CT arthrography. However, the available evidence has a high risk of bias, and total number of patients studied for each modality is small so further studies are warranted.
OBJECTIVE: The aim of this study was to compare the diagnostic accuracy of nuclear imaging modalities in the detection of aseptic loosening of total knee arthroplasty (TKA). MATERIALS AND METHODS: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched from database inception to December 2018 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies compared the results of a single imaging modality against an appropriate reference standard of prosthetic TKA loosening, with sufficient information to determine either sensitivity and/or specificity. The methodological quality of the studies was assessed using the QUADAS-2 tool. RESULTS: The search strategy identified 572 abstracts. Of these, 12 studies comprising 401 patients across four modalities (bone scintigraphy, 18F-FDG-PET, SPECT/CT arthrogram, radionuclide arthrogram) met the inclusion criteria. All included studies used operative findings, a period of clinical or radiographic observation or both as a reference standard for aseptic loosening. Sixteen comparisons with the reference standards were extracted. All studies were at risk of bias across patient selection, the index test, reference standard, and flow and timing of patients. The most accurate test for diagnosis of aseptic loosening in TKA was SPECT/CT arthrography demonstrated by the summary receiver operating characteristic curve. CONCLUSIONS: The best available evidence suggests the most accurate modality for the detection of aseptic loosening in TKA is SPECT/CT arthrography. However, the available evidence has a high risk of bias, and total number of patients studied for each modality is small so further studies are warranted.
Authors: Lawrence Chun Man Lau; Elvis Chun Sing Chui; Gene Chi Wai Man; Ye Xin; Kevin Ki Wai Ho; Kyle Ka Kwan Mak; Michael Tim Yun Ong; Sheung Wai Law; Wing Hoi Cheung; Patrick Shu Hang Yung Journal: J Orthop Translat Date: 2022-10-06 Impact factor: 4.889
Authors: Damian Wild; Martin Kretzschmar; Martin Braun; Michal Cachovan; Felix Kaul; Federico Caobelli; Markus Bäumer; A Hans Vija; Geert Pagenstert Journal: EJNMMI Res Date: 2021-06-14 Impact factor: 3.138