Frondlike Synovitis on MRI and Correlation With Polyethylene Surface Damage of Total Knee Arthroplasty

Abstract

The magnitude of frondlike hypertrophied synovitis on MRI is significantly associated with polyethylene surface damage in patients who undergo revision TKA. The finding of severe frondlike synovitis on MR images of patients with TKA should raise the possibility of polyethylene surface damage. However, time since implantation is a stronger predictor of surface damage.

MRI as Diagnostic Modality for Analyzing the Problematic Knee Arthroplasty: A Systematic Review

“…A relation was found between the presence of frondlike hypertrophied synovitis on MRI and perioperative findings of loosening due to wear . When these MRI findings were compared with the reference standard perioperative findings, the sensitivity and specificity of the diagnoses varied between 0.94–0.97 and 0.70–0.73 …”

“…These studies reported interrater reproducibilities that were almost excellent (K ≥ 0.80) and moderate (K ≥ 0.60) . One study scored frondlike hypertrophied synovitis, associated with loosening due to wear, and concluded that interrater reproducibility was good (K = 0.72) …”

“…The accuracy of MRI in diagnosing one or more of the probable causes of complaints was examined in 10 out of the 16 TKA publications, one out of the four UKA publications, and three out of the three cadaveric studies (Table ). The methodological quality of the accuracy studies assessed with QUADAS‐2 varied from a high risk of bias to a low risk of bias . Criterion validity was assessed by comparing MRI findings with perioperative findings .…”

“…This made evaluation with the reference standard possible. However, it induces selection bias, and leads to the possibility that sensitivity and specificity values were overestimated . Moreover, if image observers had known that there was always some pathology to find on the MRI, this certainly may have led them to overestimate the inter‐ and intrareproducibility values.…”

“…However, despite their adequate to very good methodological quality, these studies typically failed to indicate the time between repeated measurements. 11,[19][20][21][22][23][24][25][26][27][28] Periprosthetic joint infections were associated with signs of lamellated hyperintense synovitis on MRI. Almost excellent reproducibility results were found regarding lamellated hyperintense synovitis, with an interrater reproducibility of (K = 0.82 and K = 0.82) and intrarater reproducibility of (K = 0.83 and K = 0.89).…”