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The role of FDG-PET in distinguishing between septic and aseptic loosening in hip prosthesis: a review of literature

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Abstract

Infection in prosthesis surgery is very dangerous because it changes the patient’s prognosis. Differential diagnosis between septic and aseptic loosening is fundamental in order to apply the correct treatment. The correct diagnostic approach is still debated in literature. The aim of this study was to perform a review of literature evaluating positron emission tomography (PET) capacity to distinguish between septic and aseptic loosening in hip prosthesis. Research was done principally among medical archives. Five studies were selected which satisfied the required characteristics, and a weighted average of sensitivity and specificity of the different studies was determined. The fluorodeoxyglucose positron emission tomography (FDG-PET) sensitivity in individuating hip prosthesis infections was 82.8% and specificity was 87.3%. Positron emission tomography based on 2-fluoro-2-deoxy-D-glucose could be a valid option if research is able to find an uptake pattern specific for septic and aseptic loosening.

Résumé

Les infections en chirurgie prothétique sont très néfastes car elles peuvent changer le pronostic des patients. Le diagnostic différentiel entre complications septiques ou descellement aseptique est fondamental afin d'avoir un traitement adapté. Le diagnostic différentiel est très discuté dans la littérature. Objectif: Nous avons voulu faire une revue de la littérature afin de mettre en évidence les caractères des descellements septiques ou aseptiques dans les prothèses de hanche. Matériel et méthode: ces travaux ont été réalisés avec Medical Archives. 5 études ont été sélectionnées. Ces articles ont concerné essentiellement les possibilités de diagnostic avec la topographie par émission de protons (PET scan). Résultats: la sensibilité d'utilisation du PET Scan dans les complications infectieuses est de 82,8% et la spécificité de 87,3%. En conclusion: la technique par émission de protons à partir de 2-fluoro-2-deoxy-D-glucose est une option tout à fait intéressante qui permet de faire le diagnostic différentiel entre les descellements septiques ou aseptiques.

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Authors and Affiliations

  1. Oncological Orthopaedics Department, IFO – Regina Elena Institute, Via Elio Chianesi 53, Rome, Italy

    C. Zoccali, G. Teori & N. Salducca

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  1. C. Zoccali
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  2. G. Teori
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  3. N. Salducca
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Correspondence to C. Zoccali.

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Zoccali, C., Teori, G. & Salducca, N. The role of FDG-PET in distinguishing between septic and aseptic loosening in hip prosthesis: a review of literature. International Orthopaedics (SICO 33, 1–5 (2009). https://doi.org/10.1007/s00264-008-0575-2

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