Use of Helical Computed Tomography for the Assessment of Acetabular Osteolysis After Total Hip Arthroplasty

Yoo

Clinical Orthopaedics &Amp; Related Research

et al. 2012

Background THA in patients younger than 30 years presents challenges because of uncertainties regarding the long-term survivorship of prostheses. Alumina-on-alumina bearings, which exhibit little long-term wear, may be a reasonable option but the long-term survivorship is unknown. Questions/Purposes We determined (1) the survival rate of alumina-on-alumina bearings in patients younger than 30 years after a 10-year followup, (2) the incidence of audible hip clicking and squeaking, (3) radiographic evidence of osteolysis, and (4) the effects on pregnancy, childbirth, and career choice. Methods We retrospectively reviewed 62 patients who had 75 THAs with alumina-on-alumina bearings followed more than 10 years (average, 11.5; range, 10-13.5 years). Mean patient age at the time of surgery was 24 years (range, 18-30 years). All operations were performed using the same cementless implant at a single center. We determined survival, presence of osteolysis, and function (Harris hip score, WOMAC).

Section: Discussionmentioning

confidence: 99%

Alumina-on-alumina THA Performed in Patients Younger Than 30 Years: A 10-year Minimum Followup Study

Yoo

Clinical Orthopaedics &Amp; Related Research

et al. 2012

Clinical Orthopaedics &Amp; Related Research

“…The volume between adjacent cuts was calculated by averaging the areas between adjacent cuts multiplied by the thickness of the cuts. Summation of the volumes on each of these cuts was used to determine the total volume of bone loss due to lysis [17,27].…”

Section: Methodsmentioning

confidence: 99%

“…Two studies [17,27] demonstrate a CT scan more accurately identifies the presence, location, and extent of osteolysis than standard radiographs [2]. We therefore investigated osteolysis with CT scan on bilateral arthroplasties (one ceramic-ceramic and the contralateral ceramic-polyethylene) of patients who had survived 20 years.…”

Section: Introductionmentioning

confidence: 99%

Ceramic-Ceramic Bearing Decreases Osteolysis: A 20-year Study versus Ceramic-Polyethylene on the Contralateral Hip

Hernigou

Zilber

Filippini

et al. 2009

Although ceramic implants have been in use for many years and they are intended to minimize wear debris it is unknown whether alumina-on-alumina or alumina-onpolyethylene produce less wear and osteolysis. We therefore investigated wear and osteolysis on 28 bilateral arthroplasties (one ceramic-ceramic and the contralateral ceramic-polyethylene) of patients who had survived 20 years without revision and without loosening of either hip. Osteolysis was identified on anteroposterior pelvic radiographs and 3-D volume from CT scans. The number of osteolytic lesions detected with CT scan was higher than with radiographs. The number of lesions was higher on the side with the alumina-PE couple. With a similar length of followup on each side, the surface and the volume of osteolysis were consistently higher on the side with the alumina-PE couple. We found no correlation between the volume of osteolysis and the volume of estimated wear in each couple of friction. Hips with osteolysis had a lower Harris score.

Magnetic Resonance Imaging

“…CT may be used to detect osteolysis and, when performed at a higher kilovolt peak (140 kVp), results in improved sensitivity in the detection of osteolysis when compared to conventional radiographs (34). CT, however, remains limited in its ability to assess the surrounding soft tissues and neurovascular structures.…”

Section: Periprosthetic Osteolysismentioning

confidence: 99%

Magnetic resonance imaging of the postoperative hip

Hayter

Koff

Potter

2012

Magnetic resonance imaging (MRI) is ideally suited to imaging the patient with painful hip arthroplasty due to its superior soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation. MRI is the most accurate imaging modality in the assessment of periprosthetic osteolysis and wear‐induced synovitis, and can also assess regional tendons and neurovascular structures. This article discusses the technical aspects of MRI around metallic implants as well as the appearance of potential complications following hip arthroplasty, including osteolysis, wear‐induced synovitis, infection, hemarthrosis, fracture, loosening, component displacement, heterotopic ossification, tendinopathy, and neurovascular impingement. The specific complication of metal hypersensitivity following metal‐on‐metal prostheses is reviewed. J. Magn. Reson. Imaging 2012;35:1013‐1025. © 2012 Wiley Periodicals, Inc.