Magnetic Resonance Imaging After Total Hip Arthroplasty

Potter, Hollis G.; Nestor, Bryan J.; Sofka, Carolyn M.; Ho, Stephanie T; Peters, Lance E.; Salvati, Eduardo A.

doi:10.2106/00004623-200409000-00013

Cited by 221 publications

(165 citation statements)

References 28 publications

Supporting

Mentioning

162

Contrasting

Unclassified

Order By: Relevance

“…3). The volumes of synovitis and osteolysis were calculated using a previously validated method of manual segmentation from the coronal MAVRIC or axial FSE images [26,32]. The pseudocapsule was evaluated for dehiscence, which was characterized by either anterior or posterior capsular detachment.…”

Section: Methodsmentioning

confidence: 99%

MRI Predicts ALVAL and Tissue Damage in Metal-on-Metal Hip Arthroplasty

Nawabi

Gold

Lyman

et al. 2013

Clin Orthop Relat Res

Self Cite

123

132

View full text Add to dashboard Cite

Background Adverse local tissue reactions (ALTR) around metal-on-metal (MOM) hip arthroplasties are increasingly being recognized as a cause of failure. These reactions may be associated with intraoperative tissue damage and complication rates as high as 50% after revision. Although MRI can identify ALTR in MOM hips, it is unclear whether the MRI findings predict those at revision surgery.Questions/purposes We therefore (1) identified which MRI characteristics correlated with histologically confirmed ALTR (using the aseptic lymphocytic vasculitisassociated lesions [ALVAL] score) and intraoperative tissue damage and (2) developed a predictive model using modified MRI to detect ALVAL and quantify intraoperative tissue damage. Methods We retrospectively reviewed 68 patients with failed MOM hip arthroplasties who underwent preoperative MRI and subsequent revision surgery. Images were analyzed to determine synovial volume, osteolysis, and synovial thickness. The ALVAL score was used to grade tissue samples, thus identifying a subset of patients with ALTR. Intraoperative tissue damage was graded using a four-point scale. Random forest analysis determined the sensitivity and specificity of MRI characteristics in detecting ALVAL (score C 5) and intraoperative tissue damage. Results Maximal synovial thicknesses and synovial volumes as determined on MRI correlated with the ALVAL score and were higher in cases of severe intraoperative tissue damage. Our MRI predictive model showed sensitivity and specificity of 94% and 87%, respectively, for detecting ALVAL and 90% and 86%, respectively, for quantifying intraoperative tissue damage.

show abstract

Section: Methodsmentioning

confidence: 99%

MRI Predicts ALVAL and Tissue Damage in Metal-on-Metal Hip Arthroplasty

Nawabi

Gold

Lyman

et al. 2013

Clin Orthop Relat Res

Self Cite

123

132

View full text Add to dashboard Cite

show abstract

“…2). A characteristic line of low signal intensity surrounds the area of focal marrow replacement, distinguishing the appearance of osteolysis from tumoral replacement of bone or infection (35). A moderate echo time FSE sequence is most effective in highlighting the lesions, where the fatty marrow remains bright and the intermediate signal synovium is in contrast to the high signal intensity of the joint fluid.…”

Section: Periprosthetic Osteolysismentioning

confidence: 99%

Magnetic resonance imaging of the postoperative hip

Hayter

Koff

Potter

2012

Magnetic Resonance Imaging

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

“…In recent years, there have been numerous studies examining its role in imaging THA [3,7,38,39,46,[50][51][52]. MRI is effective for detecting periarticular bony and soft-tissue abnormalities in patients with a postarthroplasty hip [3,39,46,52], as well as determining the source of enigmatic hip following THA [7]. Due to its direct multiplanar capabilities and superior soft-tissue contrast, MRI is able to visualize intracapsular synovitis [7,39,52] and is more sensitive in the detection of osteolytic lesions than radiographs or CT [50,51].…”

Section: Introductionmentioning

confidence: 99%

“…MRI is effective for detecting periarticular bony and soft-tissue abnormalities in patients with a postarthroplasty hip [3,39,46,52], as well as determining the source of enigmatic hip following THA [7]. Due to its direct multiplanar capabilities and superior soft-tissue contrast, MRI is able to visualize intracapsular synovitis [7,39,52] and is more sensitive in the detection of osteolytic lesions than radiographs or CT [50,51]. Specifically, the ability of optimized MRI to detect wear-induced particle disease in the postarthroplasty hip has been documented in two studies that have corroborated this MRI finding with tissue pathology [39,52].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

Cooper

Ranawat

Potter

et al. 2010

Clinical Orthopaedics &Amp; Related Research

Self Cite

View full text Add to dashboard Cite

Background Little is known about intraarticular pathology following THA prior to the radiographic appearance of osteolysis, primarily due to imaging limitations. MRI has recently been applied to imaging the postarthroplasty hip with the ability to detect periarticular bony and soft tissue pathology; specifically, it is able to detect abnormal synovial patterns and focal bone loss well before the radiographic appearance of osteolysis. Questions/purposes We therefore used MRI to determine the incidence of early reactive synovitis and osteolysis in asymptomatic patients after THA, and whether there is an association between these MRI findings and clinical outcomes or radiographic wear measurements at this early stage. Methods We recruited 31 patients (33 hips) who underwent routine noncemented THA with one of three types of bearing surfaces: metal-on-cross-linked polyethylene (n = 7), ceramic-on-ceramic (n = 12), and ceramic-on-cross-linked polyethylene (n = 14). Patients underwent specialized MRI at a minimum of 12 months (mean, 23 months; range, 12-37 months) after surgery. MR images were analyzed for the presence of synovitis or osteolysis. WOMAC scores, patient assessment questionnaires, and radiographic wear measurements were correlated with MRI findings. Results Reactive synovitis was observed in 13 of 33 patients (39%) and focal osteolysis in one of 33 (3%). The presence of synovitis did not correlate with pain, activity level, patient satisfaction or clinical outcome scales, nor did it correlate with radiographic wear measurements at early followup. Conclusions Our observations suggest reactive synovitis is common yet asymptomatic at short-term followup. We do not know either the etiology or the long-term implications of these observations.

show abstract

Magnetic Resonance Imaging After Total Hip Arthroplasty

Cited by 221 publications

References 28 publications

MRI Predicts ALVAL and Tissue Damage in Metal-on-Metal Hip Arthroplasty

MRI Predicts ALVAL and Tissue Damage in Metal-on-Metal Hip Arthroplasty

Magnetic resonance imaging of the postoperative hip

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

Contact Info

Product

Resources

About