Good sensitivity and specificity of ultrasound for detecting pseudotumors in 83 failed metal-on-metal hip replacements.

Abstract:

BACKGROUND AND PURPOSE:Ultrasound is used for imaging of pseudotumors associated with metal-on-metal (MoM) hips. Ultrasound has been compared with magnetic resonance imaging, but to date there have been no studies comparing ultrasound findings and revision findings. METHODS:We evaluated the sensitivity and specificity of preoperative ultrasound for detecting pseudotumors in 82 patients with MoM hip replacement (82 hips). Ultrasound examinations were performed by 1 of 3 musculoskeletal radiologists, and pseudotumors seen by ultrasound were retrospectively classified as fluid-filled, mixed-type, or solid. Findings at revision surgery were retrieved from surgical notes and graded according to the same system as used for ultrasound findings. RESULTS:Ultrasound had a sensitivity of 83% (95% CI: 63-93) and a specificity of 92% (CI: 82-96) for detecting trochanteric region pseudotumors, and a sensitivity of 79% (CI: 62-89) and a specificity of 94% (CI: 83-98) for detecting iliopsoas-region pseudotumors. Type misclassification of pseudotumors found at revision occurred in 8 of 23 hips in the trochanteric region and in 19 of 33 hips in the iliopsoas region. INTERPRETATION:Despite the discrepancy in type classification between ultrasound and revision findings, the presence of pseudotumors was predicted well with ultrasound in our cohort of failed MoM hip replacements.

journal_name

Acta Orthop

journal_title

Acta orthopaedica

authors

Lainiala O,Elo P,Reito A,Pajamäki J,Puolakka T,Eskelinen A

doi

10.3109/17453674.2014.1001970

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

339-44

issue

3

eissn

1745-3674

issn

1745-3682

journal_volume

86

pub_type

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