Multidetector CT (MDCT) is superior to plain film x-rays for detecting problems that occur in patients who have undergone hip replacements, a new study shows.
Hip prostheses generally last 10-15 years, said Joshua Farber, MD, vice chair of clinical affairs at Indiana University Hospital in Indianapolis. Then a series of complications can occur. Dr. Farber studied 45 patients who had pain in their replaced hip, using both plain film x-rays and MDCT to diagnose the problem. MDCT was 100% accurate in detecting bone loss near the prosthesis, said Dr. Farber. That compares to a 67% accuracy rate for plain films. MDCT had an added benefit for these patients, in that it could pinpoint exactly where the bone loss had occurred so the surgeon could more easily repair the problem, said Dr. Farber.
MDCT was 100% accurate in detecting fractures near the prosthesis, compared to 94% for plain films. In addition, MDCT was 61% accurate in detecting whether the prosthesis had come loose, compared to 54% for plain films. The ability to diagnose acetabular component loosening on MDCT was influenced by the experience of the radiologists reading the examination, said Dr. Farber. “When the most experienced radiologist read the examination, the accuracy rate was 72%.”
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