Imaging Orthopedic Hardware With an Emphasis on Hip Prostheses

Eustace, Stephen; Shah, Binod; Mason, Michael D.

doi:10.1016/s0030-5898(05)70007-9

Cited by 16 publications

(3 citation statements)

References 55 publications

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“…These sequences, which are based on view angle tilting, smaller interecho spacing, increased readout bandwidth and frequency-encoding direction oriented away from the tissues of interest, can conveniently be used in conjunction with any spin-echo sequence and requires minimal additional imaging time. [6][7][8][9][10][11][12][13][14][15] Despite this, MR imaging in MoM hip replacements has been relatively unexplored and the purpose of this study is to show that MRI is feasible in patients with MoM hips and to provide an insight into the MR imaging features of the various complications associated with MoM hips.…”

Section: -7mentioning

confidence: 99%

Magnetic Resonance Imaging of Metal on Metal Implants: A Breakthrough

Pilania¹,

Jankharia²

2014

Nep J Radiology

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Background: Metal-on-metal (MoM) hip replacement, a durable alternative to conventional metal -on-polyethylene hip replacement, is increasingly common nowadays. There is a 4-8% incidence of pain and complications which usually go undetected on radiographs. MRI has a vast potential for early diagnosis in these cases. Aim: To evaluate the feasibility of MR imaging in MoM hips and to review the MR imaging features of various complications associated with metal on metal hip implants. Materials and Methods: 41 patients with 52 replaced hips using MoM prostheses underwent MRI on a 1.5T scanner using standard clinical protocols optimized to minimize metallic susceptibility artifact, known as metal artefact reduction sequences (MARS). A standardized reporting was done with specific comment on periprosthetic osteolysis, loosening, periprosthetic soft tissue mass, gluteal muscle atrophy, iliopsoas atrophy, muscle edema, muscle/ tendon tear and lymphadenopathy. Results: Diagnostic images were obtained in all patients. Of the 52 hips, 32 had total hip replacement (THR) and 20 had resurfacing. The following abnormalities were found. Periprosthetic osteolysis (5), Periprosthetic soft tissue mass (24), Gluteal muscle atrophymoderate to severe (15), Iliopsoas atrophy (15), Muscle edema (0), Muscle / tendon tear (0), Lymphadenopathy (5). Conclusion: MRI on a 1.5T scanner is a viable technique to image the MoM hip and shows well the various complications associated with post arthroplasty hips.

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Section: -7mentioning

confidence: 99%

Magnetic Resonance Imaging of Metal on Metal Implants: A Breakthrough

Pilania¹,

Jankharia²

2014

Nep J Radiology

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“…Whereas sequential indium III leukocyte scanning combined with technetium 99 bone scan has been reported to approach a specificity of 98% in some studies [14], other studies have found this combination to be of lesser value and do not advocate its use [15]. Magnetic resonance imaging can provide improved images of periprosthetic tissue with thin sections, the accuracy of which is increased by fast-spin echo, increased frequency-encoding strength, and thin sections [16,17]. Titanium prostheses provide for better imaging results than do cobaltchrome prostheses because of their relative resistance to induced magnetism.…”

Section: Radiologic Studiesmentioning

confidence: 99%

Infections associated with prosthetic knee and prosthetic hip

Lentino

2004

Curr Infect Dis Rep

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Arthroplasty of the knee and hip is a common procedure. There is a risk of infection with primary arthroplasty, with an incidence of 1% to 2%. Significant cost and morbidity are associated with infection of the prosthetic joint. Most infections (60% to 70%) are caused by staphylococci, but approximately 10% are caused by streptococci and/or enterococci, whereas the remainder are caused by gram-negative enteric aerobes or anaerobic flora. Surgical revision is often required for cure because the biofilm that adheres to the infected prosthesis precludes antibiotic therapy from being effective. Biofilm formation occurs consistently as a consequence of host protein deposition on the prostheses, which serve as ligands for bacterial receptors. Once established, biofilm infections require removal of the prosthesis in order to effect a cure. Clinical and radiologic features are not specific for the diagnosis. Culture is specific but not sensitive enough to establish a pathogen in all cases. Surgical approaches are varied and range from debridement with retention of the prostheses to amputation of the limb. The most favored approach is the two-stage delayed reimplantation, in which patients receive specific antibiotic therapy for 6 weeks or more. Several additional antibiotics other than vancomycin are available for methicillin-resistant staphylococcal infection, but these are still unproven in the treatment of osteomyelitis or prosthetic joint infection.

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“…2 The vast majority of these consist of total hip and total knee replacements. Improvements in component design and surgical techniques have not only yielded a reduction in complication rates related to joint replacements [3][4][5] but also resulted in an alteration in the relative frequency of these complications. 6 Nevertheless, a small but significant proportion of patients present with residual or recurrent symptoms, typically of pain or instability after arthroplasty, which can be a difficult challenge to evaluate and treat.…”

mentioning

confidence: 99%

Magnetic Resonance Imaging of Joint Replacements

Naraghi

White

2006

Semin Musculoskelet Radiol

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An increasing number of joint replacements are being performed annually. Complications of joint arthroplasty are diverse and may involve the hardware as well as osseous and soft tissue components. Although modalities such as conventional radiography and scintigraphy remain the mainstay of radiological investigation, in some cases these traditional methods of imaging may be negative or underestimate the extent of disease. Magnetic resonance imaging (MRI) has been considered of limited benefit following arthroplasty because of severe image degradation caused by metallic components. However, with modification of pulse sequences, artifact reduction and improved visualization of periprosthetic tissues are achievable, enabling a comprehensive assessment of articular and nonarticular pathologies. The common artifacts in the presence of orthopedic hardware, optimization of pulse sequences to minimize metal-related artifacts, and the clinical uses of MRI following joint replacement, particularly with regard to total hip arthroplasty, total knee arthroplasty, and shoulder arthroplasty, are reviewed.

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Imaging Orthopedic Hardware With an Emphasis on Hip Prostheses

Cited by 16 publications

References 55 publications

Magnetic Resonance Imaging of Metal on Metal Implants: A Breakthrough

Magnetic Resonance Imaging of Metal on Metal Implants: A Breakthrough

Infections associated with prosthetic knee and prosthetic hip

Magnetic Resonance Imaging of Joint Replacements

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