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Hofmann UK, Eleftherakis G, Migliorini F, Fink B, Mederake M. Diagnostic and prognostic relevance of plain radiographs for periprosthetic joint infections of the hip: a literature review. Eur J Med Res 2024; 29:314. [PMID: 38849967 PMCID: PMC11161982 DOI: 10.1186/s40001-024-01891-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/20/2024] [Indexed: 06/09/2024] Open
Abstract
Conventional radiography is regularly used to evaluate complications after total hip arthroplasty. In various recent consensus meetings, however, plain radiographs of a potentially infected hip joint have been judged as being only relevant to exclude diagnoses other than infection. Solid data on radiographic presentations of periprosthetic joint infection (PJI) are scarce. As a result, the prognostic value of radiological features in low-grade PJI remains uncertain. The present review article aims to present an overview of the available literature and to develop ideas on future perspectives to define the diagnostic possibilities of radiography in PJIs of the hip. The primary outcome of interest of this systematic review was the radiologic presentation of periprosthetic joint infections of the hip. As secondary outcome of interest served the sensitivity and specificity of the radiologic presentation of periprosthetic joint infections. Of the included articles, 26 were reviews, essays, or case reports and only 18 were clinical studies. Typical radiologic abnormalities of PJI were a periosteal reaction, a wide band of radiolucency at the cement-bone or metal-bone interface, patchy osteolysis, implant loosening, bone resorption around the implant, and transcortical sinus tracts. The frequency of their occurrence is still inadequately defined. A deeper understanding of the underlying causes and the relation between microorganisms to radiologic abnormalities can probably help clinicians in the future to diagnose a PJI. This is why further research shall focus on the radiographic features of PJI.
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Affiliation(s)
- Ulf Krister Hofmann
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Georgios Eleftherakis
- Department of Orthopaedic Surgery, University Hospital of Tübingen, 72076, Tübingen, Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Medical Centre, Pauwelsstraße 30, 52074, Aachen, Germany
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy
| | - Bernd Fink
- Department of Arthroplasty and Revision Arthroplasty, Orthopaedic Clinic Markgröningen GmbH, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Germany
- Orthopaedic Department, University-Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Moritz Mederake
- Department of Trauma and Reconstructive Surgery, BG Klinik, University of Tübingen, 72076, Tübingen, Germany
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Stołtny T, Pasek J, Rokicka D, Wróbel M, Dobrakowski M, Kamiński P, Domagalski R, Czech S, Strojek K, Koczy B. Are there really specific risk factors for heterotopic ossifications? A case report of 'non-risk factor' after total hip replacement. J Int Med Res 2022; 50:3000605221095225. [PMID: 35726568 PMCID: PMC9218464 DOI: 10.1177/03000605221095225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Femoral neck fractures are one of the most common fractures in the elderly population. Due to frequent complications of the fixation of these fractures, patients are more and more often eligible for hip replacement surgery. One of the most frequently mentioned postoperative complication is the formation of heterotopic ossification. This case report describes as a 70-year-old male patient that presented with an old hip fracture accompanied by a mild craniocerebral trauma. The patient underwent total cementless hip arthroplasty followed by rehabilitation. At 8 months after surgery, the patient was diagnosed with Brooker IV° heterotopic ossification in the area of the operated hip joint. Due to the persistent pain and complete loss of mobility in the operated joint, computed tomography imaging was performed and the patient was recommended for a revision surgery. The procedure was performed 14 months after the original surgical treatment, resulting in a significant improvement in the range of motion and reduction of pain.
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Affiliation(s)
- Tomasz Stołtny
- Department of Adult Orthopaedics, District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie, Poland
| | - Jarosław Pasek
- Department of Physiotherapy, Faculty of Health Sciences, University of Jan Długosz, Częstochowa, Poland
| | - Dominika Rokicka
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marta Wróbel
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Michał Dobrakowski
- Department of Medical Radiology and Radiodiagnostics, Independent Public Clinical Hospital No. 1, Zabrze, Poland.,Department of Biochemistry, Faculty of Medical Sciences, Medical University of Silesia, Zabrze, Poland
| | - Paweł Kamiński
- Department of Medical Radiology and Radiodiagnostics, Independent Public Clinical Hospital No. 1, Zabrze, Poland
| | - Rafał Domagalski
- Department of Adult Orthopaedics, District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie, Poland
| | - Szymon Czech
- Department of Adult Orthopaedics, District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie, Poland
| | - Krzysztof Strojek
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Bogdan Koczy
- Department of Adult Orthopaedics, District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie, Poland
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