The Temporal Impact of Prosthesis Implantation and Semi-Quantitative Criteria on the Diagnostic Efficacy of Triple-Phase Bone Scanning for Periprosthetic Joint Infection

Abstract

Objective: To evaluate the diagnostic efficacy of triple-phase bone scanning and the temporal impact of prosthesis implantation on the diagnostic efficacy of triple-phase bone scanning for periprosthetic joint infection (PJI). Methods: Patients who were admitted to our hospital for joint pain and dysfunction after total joint arthroplasty between 2014 and 2020 were retrospectively included. Triple-phase bone scanning was performed, and the blood pool images were evaluated to obtain the semi-quantitative criteria. The patients were then grouped into six groups according to the time interval from index primary arthroplasty to triple-phase bone scanning. We examined whether there were significant differences in sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy between the groups. Results: Overall, 66 patients who underwent total hip arthroplasty (THA) and 74 patients who underwent total knee arthroplasty (TKA) were analyzed. No significant differences were observed between visual analysis and semi-quantitative measurement in terms of sensitivity, specificity, PPV, NPV, and accuracy. For patients with a time interval from prosthesis implantation to bone scanning of >1 year, visual analysis had a higher PPV (100%) in patients who underwent THA and the use of semi-quantitative criteria had a higher NPV (85.7%) in patients who underwent TKA. Conclusion: The semi-quantitative criteria showed no advantages in the diagnosis of PJI. In addition, triple-phase bone scanning demonstrated good clinical diagnostic efficacy when the time interval from prosthesis implantation to bone scanning was >1 year.