Evidence map›Paper›PMID 28050818›Full record

SynthesisClinical orthopaedics and related research2017

What is the Accuracy of Nuclear Imaging in the Assessment of Periprosthetic Knee Infection? A Meta-analysis.

Steven J Verberne, Remko J A Sonnega, Olivier P P Temmerman, Pieter G Raijmakers

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical orthopaedics and related research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. EANM/SNMMI guideline/procedure standard for [European journal of nuclear medicine and molecular imaging · 2025
    Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. [Diagnostic value ofZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025
    Article
  7. Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. SimultaneousInternational orthopaedics · 2022
    Article
  13. The Role of Nuclear Medicine Imaging withDiagnostics (Basel, Switzerland) · 2022
    Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Steven J VerberneDepartment of Orthopaedics, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, 1815 JD, Alkmaar, NWZ, The Netherlands. stevenverberne@hotmail.com.
Remko J A SonnegaDepartment of Orthopaedics, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, 1815 JD, Alkmaar, NWZ, The Netherlands.
Olivier P P TemmermanDepartment of Orthopaedics, Noordwest Ziekenhuisgroep, Wilhelminalaan 12, 1815 JD, Alkmaar, NWZ, The Netherlands.
Pieter G RaijmakersDepartment of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the assessment of possible periprosthetic knee infection, various imaging modalities are used without consensus regarding the most accurate technique. QUESTIONS/PURPOSES: To perform a meta-analysis to compare the accuracy of various applied imaging modalities in the assessment of periprosthetic knee infection.

methodsA systematic review and meta-analysis was conducted with a comprehensive search of MEDLINE and Embase

resultsBone scintigraphy was less specific than all other modalities tested (56%; 95% CI, 0.47-0.64; p < 0.001), and leukocyte scintigraphy (77%; 95% CI, 0.69-0.85) was less specific than antigranulocyte scintigraphy (95%; 95% CI, 0.88-0.98; p < 0.001) or combined leukocyte and bone marrow scintigraphy (93%; 95% CI, 0.86-0.97; p < 0.001). Fluorodeoxyglucose positron emission tomography (FDG-PET) (84%; 95% CI, 0.76-0.90) was more specific than bone scintigraphy (56%; 95% CI, 0.47-0.64; p < 0.001), and less specific than antigranulocyte scintigraphy (95%; 95% CI, 0.88-0.98; p = 0.02) and combined leukocyte and bone marrow scintigraphy (93%; 95% CI, 0.86-0.97; p < 0.001). Leukocyte scintigraphy (88%; 95% CI, 0.81-0.93; p = 0.01) and antigranulocyte scintigraphy (90%; 95% CI, 0.78-0.96; p = 0.02) were more sensitive than FGD-PET (70%; 95% CI, 0.56-0.81). However, because of broad overlapping of confidence intervals, no differences in sensitivity were observed among the other modalities, including combined bone scintigraphy (93%; 95% CI, 0.85-0.98) or combined leukocyte and bone marrow scintigraphy (80%; 95% CI, 0.66-0.91; p > 0.05 for all paired comparisons).

conclusionsBased on current evidence, antigranulocyte scintigraphy and combined leukocyte and bone marrow scintigraphy appear to be highly specific imaging modalities in confirming periprosthetic knee infection. Bone scintigraphy was a highly sensitive imaging technique but lacks the specificity needed to differentiate among various conditions that cause painful knee prostheses. FDG-PET may not be the preferred imaging modality because it is more expensive and not more effective in confirming periprosthetic knee infection. LEVEL OF EVIDENCE: Level III, diagnostic study.

Indexed as

AdolescentAdultAgedAged, 80 and overArthroplasty, Replacement, KneeBone MarrowChildChild, PreschoolFemaleFluorodeoxyglucose F18GranulocytesHumansKnee JointKnee ProsthesisLeukocytesMaleFluorodeoxyglucose F18Radiopharmaceuticals

Identifiers

PMID28050818
PMCPMC5384926

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.