Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties

Abstract

The presented simplified CT grading system (A-C) in its first clinical validation on 48- and 64-multislice systems is reliable, showing good intra- and interrater reliability and is independently associated with revision surgery.

Selective arterial embolization as neoadjuvant treatment in hip pseudotumors

“…In addition, an investigation of the effect of the severity of disease on these variables demonstrated that the amount of bleeding and duration of operation increased as the grade increased according to the CT classification. This study also showed that the CT-based classification described by Boomsma et al [10] was useful in evaluating PT as it seems to correlate with difficulties in its excision.…”

“…Patients' preoperative hemoglobin values and bearing surfaces were reported in Table II. Pseudotumors characteristics were classified according to preoperative imaging, using both MRI [11] and CT [10] (Table II, Figure 1).…”

“…Computed tomography classification [10] Class Grade Description Digital subtraction angiography (DSA) and SAE were performed by inserting a catheter through the common femoral artery (Seldinger technique) under local anesthesia. Glubran 2 surgical glue (N-2-butyl-cyanoacrylate) was mixed with lipiodol ultrafluid (dilution 33%) and the compound was injected "sandwiched" with glucosate solution 5% to prevent polymerization with blood.…”

“…They tend to worsen progressively, both in size and pain. [9] Two different classifications (Table I) [10,11] based on magnetic resonance imaging (MRI) and computed tomography (CT) have been proposed to describe PT. These classifications take into account both the composition and the location of PT, including its potential extension inside the abdominal compartment, and can be used to predict the difficulty and risk of complications of the surgery.…”

Sequelae of large-head metal-on-metal hip arthroplasties

“…These are non-neoplastic and non-infective lesions situated in various locations in the peri-prosthetic tissue. 31,32 A pseudotumour is referred to more specifically as an adverse reaction to metal debris (ARMD), and more generally as an adverse local tissue reaction (ALTR). The term ‘aseptic lymphocytic vasculitis-associated lesion’ (ALVAL) is reserved for histological findings; 33 the term ‘metallosis’ should be avoided for these cases.…”