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Abstract #0640

MRI Is Predictive of Adverse Tissue Reaction in Failed Metal-On-Metal Hip Arthroplasty

Alissa J. Burge1, Danyal H. Nawabi2, Stephanie Gold1, Stephen Lyman3, Douglas E. Padgett2, Matthew F. Koff1, Hollis G. Potter1

1Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States; 2Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, United States; 3Division of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY, United States

An MRI classification system was developed to predict adverse local tissue reactions (ALTRs) in patients with metal-on-metal hip arthroplasty. MR images from 70 patients were assessed for osteolysis, synovitis, synovial thickness, presence of edema, synovial decompression, low signal intensity deposits, pseudocapsule dehiscence, disrupted abductors and neurovascular compression. Synovial tissues were obtained intra-operatively and were graded to assess tissue reaction. The presence and volume of synovitis, and the synovial thickness were found to correlate with histologic scoring. In patients with failed metal-on-metal (MOM) hip arthroplasty, MRI can be used to identify an adverse tissue reaction and predict the presence of soft tissue damage, helping guide the need for revision.

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Keywords

abductor acquisition adverse around arrows assess assigned audience axial blood bone bootstrapping characteristics classification clinical combination communicating compression confirmation contrast correlate correlation cups damage decompression defined demarcated deposits detecting detection determined develop diagnose diagnosis disruption distinguishing early edema electric epidemiology evaluate evaluated expansion extent failed failing failures fast features finding findings fisher fluid forest future grades hips histological hospital identify identifying implant increasing indicated infiltrates inflammatory integrity intensity intra ionizing lesions likely lining local machine male material maximal measured mechanical median metal mixed morphology necrosis nodes none normalization operatively outcome outcomes patients pattern poor predict predictive predictor predictors preoperative presence produces proportion protocols quantitative random rank reaction reactions recent replacements replacing reports respectively resurfacing revision risk score screening secondary sensitivity severe significantly slice soft solid spacing special specificity strong studies subsequent superior superiorly support surgeons surgery symptomatic system target thickening thicknesses timely tissue tool type underwent utilizing volume volumes wear white