Intracapsular pressure monitoring during arthrographic evaluation of painful hip prostheses

Cone, RO; Yaru, N; Resnick, Donald; Gershuni, David H.; Guerra, Juan Carlos Pérez

doi:10.2214/ajr.141.5.885

Cited by 12 publications

(2 citation statements)

References 13 publications

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“…Based on arthrographic studies (Hendrix et al (1983); Cone et al (1983)), in which it can be seen that the contrast agent injected to the joint capsule immediately finds its way to the interfacial gaps and osteolytic lesions in communication with them, it was assumed that the synovial fluid occupies the interfacial gaps and it can easily flow to the interface. The fluid flowing in the capsule, gap and the bone was, therefore, modelled with the properties of liquid water with constant viscosity and density of 0.001 kg/ms and 998.2 kg/m3, respectively.…”

Section: Methodsmentioning

confidence: 99%

The implication of the osteolysis threshold and interfacial gaps on periprosthetic osteolysis in cementless total hip replacement

Alidousti

Bressloff

2017

Journal of Biomechanics

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Osteolysis around joint replacements may develop due to migration of wear particles from the joint space into gaps between the interface bone and the implant where they can accumulate in high concentrations to cause tissue damage. Osteolysis may appear in various postoperative times and morphological shapes which can be generalized into linear and focal. However, there are no clear explanations on the causes of such variations. Patients' degree of sensitivity to polyethylene particles (osteolysis thresholds), the local particle concentration and the access route provided by the interface gaps have been described as determining factors. To study their effects, a 2D computational fluid dynamics model of the hip joint capsule in communication with an interfacial gap and the surrounding bone was employed. Particles were presented using a discrete phase model (DPM). High capsular fluid pressure was considered as the driving force for particle migration. Simulations were run for different osteolysis thresholds ranging from 5×10 to 1×10 particle number per gram of tissue and fibrous tissue generation in osteolytic lesion due to particles was simulated for the equivalent of ten postoperative years. In patients less sensitive to polyethylene particles (higher threshold), osteolysis may be linear and occur along an interfacial gap in less than 5% of the interfacial tissue. Focal osteolysis is more likely to develop in patients with higher sensitivity to polyethylene particles at distal regions to an interfacial gaps where up to 80% of the interfacial tissue may be replaced by fibrous tissue. In these patients, signs of osteolysis may also develop earlier (third postoperative year) than those with less sensitivity who may show very minor signs even after ten years. This study shows the importance of patient sensitivity to wear particles, the role of interfacial gaps in relation to morphology and the onset of osteolysis. Consequently, it may explain the clinically observed variation in osteolysis development.

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Section: Methodsmentioning

confidence: 99%

The implication of the osteolysis threshold and interfacial gaps on periprosthetic osteolysis in cementless total hip replacement

Alidousti

Bressloff

2017

Journal of Biomechanics

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“…Standard arthrographic technique was used with emphasis on achieving a high intraarticular pressure during injection to decrease the number of false-negative results [5,10]. A conventional anteroposterior (AP) radiograph was obtained prior to the insertion of a 20 gauge spinal needle into the hip joint through an anterior approach.…”

Section: Methodsmentioning

confidence: 99%

Arthrography of painful hips following arthroplasty: digital versus plain film subtraction

et al. 1991

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Digital and manual subtraction images obtained during the arthrographic evaluation of 78 painful hip prostheses were reviewed retrospectively. Revision arthroplasty was performed in 53 of these cases, and the arthrographic and surgical findings were correlated. The digital and manual subtraction images were evaluated without knowledge of the surgical results using established criteria for component loosening. Digital subtraction arthrography of the femoral component demonstrated a 96% sensitivity and 100% specificity for the diagnosis of component loosening. Sensitivity and specificity for acetabular component loosening were 83% and 80%, respectively. Plain film subtraction of the femoral component demonstrated a 79% sensitivity and 100% specificity; the sensitivity and specificity for the acetabular component were 75% and 80%, respectively. The difference between detection of femoral component loosening on digital as opposed to manual subtraction images was statistically significant (P less than 0.05). This study demonstrate that digital subtraction improves the evaluation of femoral component loosening in painful hip prostheses.

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Radiographic Evaluation of the Painful Total Hip Arthroplasty

Newberg¹,

Wetzner²,

Ellis³

1999

Revision Total Hip Arthroplasty

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Intracapsular pressure monitoring during arthrographic evaluation of painful hip prostheses

Cited by 12 publications

References 13 publications

The implication of the osteolysis threshold and interfacial gaps on periprosthetic osteolysis in cementless total hip replacement

The implication of the osteolysis threshold and interfacial gaps on periprosthetic osteolysis in cementless total hip replacement

Arthrography of painful hips following arthroplasty: digital versus plain film subtraction

Radiographic Evaluation of the Painful Total Hip Arthroplasty

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