[Revision Total Knee Arthroplasty].

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: ja; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: ja; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein. Erklärung zu nichtfinanziellen Interessen Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht. 16. J Am Coll Radiol. 2023 Nov;20(11S):S413-S432. doi: 10.1016/j.jacr.2023.08.015. ACR Appropriateness Criteria® Imaging After Total Hip Arthroplasty. Expert Panel on Musculoskeletal Imaging; Weissman BN(1), Palestro CJ(2), Fox MG(3), Bell AM(4), Blankenbaker DG(5), Frick MA(6), Jawetz ST(7), Kuo PH(8), Said N(9), Stensby JD(10), Subhas N(11), Tynus KM(12), Walker EA(13), Kransdorf MJ(14). Author information: (1)Harvard Medical School, Boston, Massachusetts. Electronic address: bweissman22@gmail.com. (2)Research Author, Long Island Jewish Medical Center, New Hyde Park, New York. (3)Panel Chair, Mayo Clinic Arizona, Phoenix, Arizona. (4)Rush University Medical Center, Chicago, Illinois; American College of Physicians. (5)University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. (6)Mayo Clinic, Rochester, Minnesota. (7)Hospital for Special Surgery, New York, New York. (8)University of Arizona, Tucson, Arizona; Commission on Nuclear Medicine and Molecular Imaging. (9)Duke University Medical Center, Durham, North Carolina. (10)University of Missouri Health Care, Columbia, Missouri. (11)Cleveland Clinic, Cleveland, Ohio. (12)Northwestern Memorial Hospital, Chicago, Illinois; American College of Physicians. (13)Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania; Uniformed Services University of the Health Sciences, Bethesda, Maryland. (14)Specialty Chair, Mayo Clinic, Phoenix, Arizona. This article reviews evidence for performing various imaging studies in patients with total hip prostheses. Routine follow-up is generally performed with radiography. Radiographs are also usually the initial imaging modality for patients with symptoms related to the prosthesis. Following acute injury with pain, noncontrast CT may add information to radiographic examination regarding the presence and location of a fracture, component stability, and bone stock. Image-guided joint aspiration, noncontrast MRI, and white blood cell scan and sulfur colloid scan of the hip, are usually appropriate studies for patients suspected of having periprosthetic infection. For evaluation of component loosening, wear, and/or osteolysis, noncontrast CT or MRI are usually appropriate studies. Noncontrast MRI is usually appropriate for identifying adverse reaction to metal debris related to metal-on-metal articulations. For assessing patients after hip arthroplasty, who have trochanteric pain and nondiagnostic radiographs, ultrasound, or MRI are usually appropriate studies. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jacr.2023.08.015