Systematic review of single stage revision for prosthetic joint infection.

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Abstract

Conflict of interest statement: Conflict-of-interest statement: Authors declare no conflict of interests for this article. 20. J Am Coll Radiol. 2023 Nov;20(11S):S433-S454. doi: 10.1016/j.jacr.2023.08.014. ACR Appropriateness Criteria® Imaging After Total Knee Arthroplasty: 2023 Update. Expert Panel on Musculoskeletal Imaging; Walker EA(1), Fox MG(2), Blankenbaker DG(3), French CN(4), Frick MA(5), Hanna TN(6), Jawetz ST(7), Onks C(8), Said N(9), Stensby JD(10), Beaman FD(11). Author information: (1)Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania; Uniformed Services University of the Health Sciences, Bethesda, Maryland. Electronic address: ewalker@pennstatehealth.psu.edu. (2)Panel Chair, Mayo Clinic Arizona, Phoenix, Arizona. (3)University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. (4)Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. (5)Mayo Clinic, Rochester, Minnesota. (6)Emory University, Atlanta, Georgia; Committee on Emergency Radiology-GSER. (7)Hospital for Special Surgery, New York, New York. (8)Penn State Health, Hershey, Pennsylvania, Primary care physician. (9)Duke University Medical Center, Durham, North Carolina. (10)University of Missouri Health Care, Columbia, Missouri. (11)Specialty Chair, University of Kentucky, Lexington, Kentucky. Total knee arthroplasty is the most commonly performed joint replacement procedure in the United States. This manuscript will discuss the recommended imaging modalities for six clinical variants; 1. follow-up of symptomatic or asymptomatic patients with a total knee arthroplasty. Initial imaging, 2. Suspected infection after total knee arthroplasty. Additional imaging following radiographs, 3. Pain after total knee arthroplasty. Infection excluded. Suspect aseptic loosening or osteolysis or instability. Additional imaging following radiographs, 4. Pain after total knee arthroplasty. Suspect periprosthetic or hardware fracture. Additional imaging following radiographs, 5. Pain after total knee arthroplasty. Measuring component rotation. Additional imaging following radiographs, and 6. Pain after total knee arthroplasty. Suspect periprosthetic soft-tissue abnormality unrelated to infection, including quadriceps or patellar tendinopathy. Additional imaging following radiographs. 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.2023.08.014