Magnetic Resonance Imaging Findings in Symptomatic Versus Asymptomatic Subjects Following Metal-on-Metal Hip Resurfacing Arthroplasty

Nawabi, Danyal H.; Hayter, Catherine L.; Su, Edwin P.; Koff, Matthew F.; Perino, Giorgio; Gold, Stephanie; Koch, Kevin M.; Potter, Hollis G.

doi:10.2106/jbjs.k.01476

Cited by 66 publications

(54 citation statements)

References 2 publications

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“…Good repeatability was demonstrated between examiners for the assessment of synovial volume using MRI. Although synovitis was noted in a similar proportion of all groups, osteolysis was rare [28]. Further longitudinal assessment of these cohorts could potentially disclose the clinical relevance of smaller synovial volumes in these patients in a variety of bearing surfaces.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 87%

“…Recent studies pertaining to MRI have focused on potential predictive factors of soft tissue destruction seen intraoperatively at the time of revision surgery [27][28][29]. In predictive models, the maximum synovial thickness and the presence of solid synovial deposits on MRI have greater sensitivity and specificity in detecting ALVAL scores and quantifying intraoperative tissue damage than isolated serum ion levels (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Advantages of MRI include the enhanced soft tissue detail it provides in addition to its potential promise in predicting not only the presence, but also severity of an adverse local tissue reaction [28,29]. However, disadvantages include the cost associated with its use along with differences in the accessibility of specific sequencing protocols at different institutions.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…However, disadvantages include the cost associated with its use along with differences in the accessibility of specific sequencing protocols at different institutions. MRI with or without MARS has been the most commonly reported surveillance mechanism for the presence of wear-related corrosion problems in hip arthroplasty [8,11,12,16,17,[28][29][30]. The use of specific, metal artifact reduction sequences such as MAVRIC (multiple acquisition variable-resonance image combination) and SEMAC (slice encoding for metal artifact correction) has increased the ability to both identify and characterize these soft tissue lesions [18,20,25].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

See 3 more Smart Citations

What Are the Advantages and Disadvantages of Imaging Modalities to Diagnose Wear-related Corrosion Problems?

Nam

Barrack

Potter

2014

Clin Orthop Relat Res

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Background Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing arthroplasty (SRA). A variety of imaging tools, including ultrasound (US), CT, and MRI, have been used to diagnose problems associated with wear after MoM hip arthroplasty and corrosion at the head-trunnion junction; however, the relative advantages and disadvantages of each remain a source of controversy. Questions/purposes The purposes of this review were to evaluate the advantages and disadvantages of (1) US; (2) CT; and (3) MRI as diagnostic tools in the assessment of wear-related corrosion problems after hip arthroplasty. Methods A systematic literature review was performed through Medline, EMBASE, Scopus CINAHL, and the Cochrane Library without time restriction using search terms related to THA, SRA, US, CT, MRI, adverse tissue reactions, and corrosion. Inclusion criteria were Level I through IV studies in the English language, whereas expert opinions and case reports were excluded. The quality of included studies was judged by their level of evidence, method of intervention allocation, outcome assessments, and followup of patients. Four hundred ninety unique results were returned and 40 articles were reviewed.

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Section: Magnetic Resonance Imagingmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

See 2 more Smart Citations

What Are the Advantages and Disadvantages of Imaging Modalities to Diagnose Wear-related Corrosion Problems?

Nam

Barrack

Potter

2014

Clin Orthop Relat Res

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“…This observation implies that earlier recognition of the clinical entity and diagnosis prompting earlier intervention may play a role in reducing the complications associated with wear and corrosion. Current research is focusing on routine use of three-dimensional imaging to diagnose corrosion and MoM wear problems before there is extensive soft tissue damage [16,35]. Many of the studies we identified also mentioned the use of metal level testing.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Engh

Padgett

2014

Clin Orthop Relat Res

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Background Wear and corrosion occurring in patients with hip and knee arthroplasty are common causes of failure leading to revision surgery. A variety of surgical approaches to these problems have been described, with varying efficacy. Polyethylene wear, metal-on-metal (MoM) hip bearing wear, and problems associated with modular taper corrosion are the areas of greatest clinical impact; results of revisions for these problems are likely to dictate a large portion of revision resources for the foreseeable future, and so they call for specific study. Questions/purposes We identified the most frequently reported procedures to treat hip polyethylene wear, knee polyethylene wear, MoM wear after THA, and modular taper corrosion and determined the timing and reasons these failed. Methods We performed systematic reviews of the published literature on the four topics using MEDLINE 1 and Embase in October 2013; searches were supplemented by hand searches of bibliographies. Prespecified criteria resulted in the identification of 38 relevant articles, of which 33 were either case reports or Level IV evidence. Followup was generally at short term and ranged from 0.2 to 8 years. Results The most frequently reported procedures for treating clinically important wear were a partial or complete revision. When treating polyethylene wear, the more frequently reported reasons for hip and knee rerevisions were loosening, continued wear, and instability. Soft tissue reactions were more common and occasionally extensive in patients with MoM or modular taper corrosion. Patients with soft tissue reactions had more complications and higher rerevision rates. Conclusions Studies with longer followup and higher levels of evidence are needed to direct the treatment of wear and corrosion. When soft tissue damage secondary to MoM wear or taper corrosion is present, the results of treatment can be poor. There is an urgent need to better understand these two mechanisms of failure.

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Multivariate use of MRI biomarkers to classify histologically confirmed necrosis in symptomatic total hip arthroplasty

Sherafati

Bauer

Potter

et al. 2020

Journal Orthopaedic Research

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The failure of total hip arthroplasty (THA) is commonly associated with the necrosis of the periprosthetic tissue. To date, there is no established method to noninvasively quantify the progression of such necrosis. Magnetic resonance imaging (MRI) of soft tissues near implants has undergone a recent renaissance due to the development of multispectral metal‐artifact reduction techniques. Advanced analysis of multispectral MRI has been shown capable of detecting small magnetism effects of metallic debris in periprosthetic tissue. The purpose of this study is to demonstrate the diagnostic utility of these MRI‐based tissue‐magnetism signatures. Together with morphological MRI metrics, such as synovial volume and thickness, these measurements are utilized as biomarkers to noninvasively detect soft‐tissue necrosis in symptomatic THA patients (N=78). All subjects underwent an advanced MRI scan before revision surgery and tissue biopsies utilized for necrosis grading. Statistical analyses demonstrated a weak, but significant positive correlation (P = .04) between MRI magnetism signatures and necrosis scores, while indicating no meaningful association between the latter and serum cobalt and chromium ion levels. Receiver‐operating characteristic (ROC) analyses were then performed based on uni‐ and multivariate logistic regression models utilizing the measured MRI biomarkers as predictors of severe necrosis. The area under the curve of the ROC plots for MRI biomarkers as combined predictors were found to be 0.70 and 0.84 for cross‐validation and precision‐recall tests, respectively.

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Magnetic Resonance Imaging Findings in Symptomatic Versus Asymptomatic Subjects Following Metal-on-Metal Hip Resurfacing Arthroplasty

Cited by 66 publications

References 2 publications

What Are the Advantages and Disadvantages of Imaging Modalities to Diagnose Wear-related Corrosion Problems?

What Are the Advantages and Disadvantages of Imaging Modalities to Diagnose Wear-related Corrosion Problems?

The Surgical Options and Clinical Evidence for Treatment of Wear or Corrosion Occurring With THA or TKA

Multivariate use of MRI biomarkers to classify histologically confirmed necrosis in symptomatic total hip arthroplasty

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