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Semin Musculoskelet Radiol 2013; 17(01): 049-055
DOI: 10.1055/s-0033-1333914
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ultrasound of the Postoperative Hip

Joseph G. Craig
1   Department of Radiology, Henry Ford Hospital, Detroit, Michigan
› Institutsangaben
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Publikationsdatum:
13. März 2013 (online)

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Abstract

Imaging of the postoperative hip with ultrasound can be difficult and challenging. The primary role of ultrasound is to help determine whether or not there is infection. It is difficult at times to differentiate between complex fluid and synovium. Whether fluid is infected or not cannot be determined by ultrasound criteria and aspiration, and laboratory analysis is required. Particle disease and infection cannot be reliably differentiated by ultrasound criteria. In the setting of possible infection, any fluid collection/s around the hip should be treated with suspicion and, if possible, aspirated. The importance of sending part of the aspirated fluid for cell count is stressed; aspirated synovial fluid with a cell count >3000 white blood cells per milliliter of aspirated synovial fluid when combined with an elevated erythrocyte sedimentation rate and C-reactive protein level is highly predictive of infection.

Keywords

postoperative hip - total hip joint replacement - infection - particle disease
 

  • References

  • 1 Gillespie WJ. Prevention and management of infection after total joint replacement. Clin Infect Dis 1997; 25 (6) 1310-1317
    CrossrefPubMedGoogle Scholar
  • 2 Coventry MB. Treatment of infections occurring in total hip surgery. Orthop Clin North Am 1975; 6 (4) 991-1003
    PubMedGoogle Scholar
  • 3 Schmalzried TP, Amstutz HC, Au MK, Dorey FJ. Etiology of deep sepsis in total hip arthroplasty. The significance of hematogenous and recurrent infections. Clin Orthop Relat Res 1992; 280 (280) 200-207
    PubMedGoogle Scholar
  • 4 Tsukayama DT, Estrada R, Gustilo RB. Infection after total hip arthroplasty. A study of the treatment of one hundred and six infections. J Bone Joint Surg Am 1996; 78 (4) 512-523
    CrossrefPubMedGoogle Scholar
  • 5 Crichton PB, Anderson LA, Phillips G, Davey PG, Rowley DI. Subspecies discrimination of staphylococci from revision arthroplasties by ribotyping. J Hosp Infect 1995; 30 (2) 139-147
    CrossrefPubMedGoogle Scholar
  • 6 van Holsbeeck MT, Eyler WR, Sherman LS , et al. Detection of infection in loosened hip prostheses: efficacy of sonography. AJR Am J Roentgenol 1994; 163 (2) 381-384
    CrossrefPubMedGoogle Scholar
  • 7 Kung JW, Yablon C, Huang ES, Hennessey H, Wu JS. Clinical and radiologic predictive factors of septic hip arthritis. AJR Am J Roentgenol 2012; 199 (4) 868-872
    CrossrefPubMedGoogle Scholar
  • 8 Schinsky MF, Della Valle CJ, Sporer SM, Paprosky WG. Perioperative testing for joint infection in patients undergoing revision total hip arthroplasty. J Bone Joint Surg Am 2008; 90 (9) 1869-1875
    CrossrefPubMedGoogle Scholar
  • 9 Pfirrmann CWA, Notzli HP, Dora C, Hodler J, Zanetti M. Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology 2005; 235 (3) 969-976
    CrossrefPubMedGoogle Scholar
  • 10 Garcia FL, Picado CHF, Nogueira-Barbosa MH. Sonographic evaluation of the abductor mechanism after total hip arthroplasty. J Ultrasound Med 2010; 29 (3) 465-471
    PubMedGoogle Scholar
  • 11 Twair A, Ryan M, O'Connell M, Powell T, O'Byrne J, Eustace S. MRI of failed total hip replacement caused by abductor muscle avulsion. AJR Am J Roentgenol 2003; 181 (6) 1547-1550
    CrossrefPubMedGoogle Scholar
  • 12 Zhu YH, Chiu KY, Tang WM. Review Article: Polyethylene wear and osteolysis in total hip arthroplasty. J Orthop Surg (Hong Kong) 2001; 9 (1) 91-99
    PubMedGoogle Scholar
  • 13 Gallo J, Kamínek P, Tichá V, Riháková P, Ditmar R. Particle disease. A comprehensive theory of periprosthetic osteolysis: a review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2002; 146 (2) 21-28
    CrossrefPubMedGoogle Scholar
  • 14 Watters TS, Cardona DM, Menon KS, Vinson EN, Bolognesi MP, Dodd LG. Aseptic lymphocyte-dominated vasculitis-associated lesion: a clinicopathologic review of an underrecognized cause of prosthetic failure. Am J Clin Pathol 2010; 134 (6) 886-893
    CrossrefPubMedGoogle Scholar
  • 15 Daniel J, Holland J, Quigley L, Sprague S, Bhandari M. Pseudotumors associated with total hip arthroplasty. J Bone Joint Surg Am 2012; 94 (1) 86-93
    CrossrefPubMedGoogle Scholar
  • 16 Brodner W, Bitzan P, Meisinger V, Kaider A, Gottsauner-Wolf F, Kotz R. Serum cobalt levels after metal-on-metal total hip arthroplasty. J Bone Joint Surg Am 2003; 85-A (11) 2168-2173
    PubMedGoogle Scholar
  • 17 Jacobs JJ, Skipor AK, Doorn PF , et al. Cobalt and chromium concentrations in patients with metal on metal total hip replacements. Clin Orthop Relat Res 1996; 329 (329, Suppl) S256-S263
    CrossrefPubMedGoogle Scholar
  • 18 Lhotka C, Szekeres T, Steffan I, Zhuber K, Zweymüller K. Four-year study of cobalt and chromium blood levels in patients managed with two different metal-on-metal total hip replacements. J Orthop Res 2003; 21 (2) 189-195
    CrossrefPubMedGoogle Scholar