Lymphatic filling in arthrography following total hip replacement

Area of Science:

• Orthopedic surgery
• Radiology
• Infectious disease

Background:

• Lymphatic opacification during hip arthrography is of uncertain significance.
• A potential link to prosthetic hip loosening could increase surgical exploration.

Purpose of the Study:

• To determine if lymphatic filling during hip arthrography correlates with prosthetic hip loosening.
• To investigate the relationship between lymphatic opacification and prosthetic joint infection.

Main Methods:

• Retrospective assessment of 92 hip arthrograms and plain radiographs.
• Evaluation of 91 patients undergoing hip arthrography for prosthetic hip assessment.
• Correlation analysis between lymphatic filling and radiological evidence of loosening or subsequent surgical findings.

Main Results:

• Radiological loosening was present in 61 patients; 53 underwent surgery with 50 confirmed loose/infected components.
• Lymphatic filling was demonstrated in only 18 of the 50 surgically confirmed loose/infected cases.
• Lymphatic opacification occurred in 10 of 23 patients with no evidence of loosening.

Conclusions:

• This study found no correlation between lymphatic filling during hip arthrography and prosthetic hip loosening or infection.
• The findings contradict a previous report suggesting a link between lymphatic opacification and prosthetic loosening.
• Lymphatic filling during hip arthrography is not a reliable indicator of prosthetic hip loosening or infection.