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Metal Artifact Reduction Sequence MRI Abnormalities Occur in Metal-on-polyethylene Hips

  • Symposium: 2014 Hip Society Proceedings
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

To determine the importance of MRI abnormalities in metal-on-metal (MoM) bearings, it is important to understand the baseline features of this diagnostic tool in conventional metal-on-polyethylene (MoP) bearings.

Questions/purposes

What are the frequency, size, and types of MRI-documented adverse local tissue reactions in asymptomatic patients with MoP bearings?

Methods

We recruited 50 patients 5 years after a MoP total hip arthroplasty from a pool of patients in our joint registry who had a Harris hip score of > 90. To be included, patients had to be without pain and have adequate radiographs. Our data set included 50 asymptomatic patients with MoP bearings who underwent a metal artifact reduction sequence MRI.

Results

MRI abnormalities were seen in 14 of 50 (28%) asymptomatic patients who were studied. Thirteen of the 14 abnormalities were cystic thin-walled lesions with a mean of 18 cm3 (range, 1–79 cm3).

Conclusions

MRI abnormalities were noted in nearly one-third of asymptomatic patients with MoP bearings. Decisions concerning revision of MoM bearings should not be based on isolated MRI findings because MRI abnormalities are commonly seen regardless of bearing type. A number of factors should determine the need for intervention including pain, mechanical symptoms, abductor weakness, component type, component position, and ion levels as well as MRI findings.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank OrthoCarolina Research Institute, Inc. Special thanks to Rebecca Haug for her hard work and dedication to the study and the study patients.

Author information

Authors and Affiliations

  1. OrthoCarolina Hip and Knee Center, 2001 Vail Avenue, Suite 200A, Charlotte, NC, 28209, USA

    Thomas K. Fehring MD

  2. Virginia Commonwealth University Medical Center, West Hospital, Richmond, VA, USA

    Keith Fehring MD

  3. OrthoCarolina Research Institute, Charlotte, NC, USA

    Susan M. Odum PhD

Authors
  1. Thomas K. Fehring MD
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  2. Keith Fehring MD
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  3. Susan M. Odum PhD
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Corresponding author

Correspondence to Thomas K. Fehring MD.

Additional information

The institution of one or more authors (TKF) has received, during the study period, funding from Carolinas Healthcare Foundation, Winkler Orthopaedic Fellowship Fund. One of the authors certifies that he (TKF), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of USD 100,001 to USD 1,000,000 from DePuy Orthopaedics (Warsaw, IN, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research ® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that the study was approved by an institutional review board, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at OrthoCarolina Hip and Knee Center, Charlotte, NC, USA.

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Fehring, T.K., Fehring, K. & Odum, S.M. Metal Artifact Reduction Sequence MRI Abnormalities Occur in Metal-on-polyethylene Hips. Clin Orthop Relat Res 473, 574–580 (2015). https://doi.org/10.1007/s11999-014-3873-6

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  • DOI: https://doi.org/10.1007/s11999-014-3873-6

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