Diagnostic value of digital subtraction arthrography (DSAr) and radionuclide arthrography (AS) in planning revesion operation in hip endoprothesis loosening.

Purpose: Clinical and radiographic findings are of little value in the diag nosis of hip endoprothesis loosening. Refined contrast and radionuclide art hrographic techniques are more precise in predicting endoprothesis loosenin g. Here we compare both techniques with respect to the surgical result. Mat erial and methods: 68 patients with hip pain after various arthroplasty pro cedure were investigated by clinical examination, X-ray, DSAr and AS. Surgi cal proof was obtained in 73.5%. Results: An acetabular component loosening was detected in 89% by DSAr and in 86% by AS with a specificity for both m ethods of 93%. The femoral component loosening was seen with a sensitivity of 89% by DSAr and 100% by AS, respectively. Specificity of DSAr in the fem oral compartment was 94%, of AS 88%. Conclusions: DSAr and AS are useful to ots in the diagnosis of hip endoprothesis loosening and in planning surgica l treatment. Both methods are comparable concerning the acetabular componen t,whereas AS is more sensitive in detecting femoral stem loosening. Combina tion of both methods is not recommended for routine diagnosis.