Monitoring Pelvic Osteolysis Following Total Hip Replacement Surgery

Stulberg, S. David; Wixson, Richard L.; Adams, Angela D.; Hendrix, Ronald W.; Bernfield, Jeffrey B.

doi:10.2106/00004623-200200002-00016

Cited by 51 publications

(38 citation statements)

References 15 publications

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“…The CT protocol was a metal artifact suppression technique that involved reconstruction in the axial, coronal, and sagittal planes. These CT scans were then independently evaluated by two authors (TCM, SDS) and an independent radiologist (RY), all blinded to the clinical and plain radiographic results; this protocol has been used extensively at our institution to evaluate a number of different implant designs and combinations [26,32]. Osteolysis was defined as any sharply demarcated area adjacent to the acetabular or femoral implant devoid of osseous trabeculae, with or without sclerotic margins [6,19,26,32,34].…”

Section: Methodsmentioning

confidence: 99%

“…However, that study used plain radiographs to evaluate osteolysis and bone ingrowth. Multiple studies suggest radiographs underestimate the incidence and extent of osteolysis [10,14,19,27,28,34,38], and several authors state helical CT is the modality of choice to detect these lesions [19,26,32,34]. Thus, the true incidence of osteolysis with this implant is unclear.…”

Section: Introductionmentioning

confidence: 99%

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A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Moen

Ghate²,

Salaz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Aseptic osteolysis has been the single most important factor limiting the longevity of a THA. A great deal of attention has been focused on the development of implants and materials that minimize the development of osteolysis. The monoblock porous tantalum acetabular cup was designed to minimize osteolysis, but whether it does so is unclear. Questions/purposes We evaluated the incidence of osteolytic lesions after THA using a monoblock porous tantalum acetabular component. Methods We retrospectively reviewed 51 patients who had a THA using a monoblock porous tantalum acetabular cup. At a minimum of 9.6 years postoperatively (average, 10.3 years; SD, 0.2 years; range, 9.6-10.8 years), a helical CT scan of the pelvis using a metal suppression protocol was obtained. This scan was evaluated for the presence of osteolysis.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Moen

Ghate²,

Salaz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Progressive osteolysis is a threat to the longevity of a hip arthroplasty and regular followup of patients with serial radiographs ensures changes are monitored even in the absence of symptoms [4,19,39,43]. The measurement of the area of osteolysis on radiographs has not been achieved easily [9,12].…”

Section: Discussionmentioning

confidence: 99%

“…These results support the interchangeability of its use by any member of an orthopaedic team conducting routine surveillance. The purpose of surveillance is to facilitate timely intervention to improve the outcome for patients and potentially reduce the cost of surgery [23,39,43]. Additionally, reliable measurements obtained with the morphometric grid may provide evidence of the prevalence of osteolysis for specific acetabular components to assist a surgeon in his or her choice of prosthesis [39].…”

Section: Discussionmentioning

confidence: 99%

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Use of Morphometry to Quantify Osteolysis after Total Hip Arthroplasty

Smith

Cramp

Palmer

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Progressive osteolysis threatens the longevity of hip arthroplasties and radiographic review is recommended. Measurement of osteolytic lesions in a clinical setting has not been achieved easily in the past. Other radiologic investigations provide accurate information but cost and risk to the patient prohibit their use in routine review. Questions/purposes We developed a simple, reliable tool to be used in hip arthroplasty review to quantify osteolytic changes seen on plain film radiographs. Methods A morphometric grid was developed and tested on simulated and actual osteolytic lesions. Four health professionals measured lesions on each of two occasions. Intraclass correlation coefficients (ICC) for interobserver and intraobserver reliabilities were calculated and BlandAltman plots were constructed for graphic analysis. ResultsThe ICCs for interobserver reliability on the simulated and actual osteolytic lesions were in the range 0.90 to 0.96. The values for intraobserver (test-retest) reliability were 0.97 to 0.98. The Bland-Altman plots confirmed agreement and in each case, proximity of the mean to zero indicated no significant bias. Conclusions The data show a morphometric grid is reliable for measuring osteolytic changes after hip arthroplasty. Clinical Relevance This tool has potential to improve monitoring processes for hip arthroplasty and to be useful in future research studies. Additional work is needed to test for validity and clinical importance of the measurements obtained.

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MR imaging with metal artifact-reducing sequences and gadolinium contrast agent in a case-control study of periprosthetic abnormalities in patients with metal-on-metal hip prostheses

et al. 2014

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MARS and gadolinium subtraction imaging are useful for evaluation of complications to MoM prosthesis. TSE VAT had the highest sensitivity for osteolysis. Contrast enhancement might indicate activation of aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Pain, small head, or steep prosthesis inclination angle are not useful predictors of periprosthetic abnormalities, and wide indications for MR follow-up are warranted.

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Monitoring Pelvic Osteolysis Following Total Hip Replacement Surgery

Cited by 51 publications

References 15 publications

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

A Monoblock Porous Tantalum Acetabular Cup Has No Osteolysis on CT at 10 Years

Use of Morphometry to Quantify Osteolysis after Total Hip Arthroplasty

MR imaging with metal artifact-reducing sequences and gadolinium contrast agent in a case-control study of periprosthetic abnormalities in patients with metal-on-metal hip prostheses

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