NDLI: What are the advantages and disadvantages of imaging modalities to diagnose wear-related corrosion problems?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nam, Denis Barrack, Robert L. Potter, Hollis G.
Description	Author Affiliation: Nam D ( Department of Orthopedic Surgery, Washington University School of Medicine/Barnes-Jewish Hospital, St Louis, MO, USA, namd@wudosis.wustl.edu.)
Abstract	BACKGROUND: Adverse tissue reactions are known to occur after total hip arthroplasty using both conventional and metal-on-metal (MoM) bearings and after MoM hip resurfacing arthroplasty (SRA). A variety of imaging tools, including ultrasound (US), CT, and MRI, have been used to diagnose problems associated with wear after MoM hip arthroplasty and corrosion at the head-trunnion junction; however, the relative advantages and disadvantages of each remain a source of controversy. QUESTIONS/PURPOSES: The purposes of this review were to evaluate the advantages and disadvantages of (1) US; (2) CT; and (3) MRI as diagnostic tools in the assessment of wear-related corrosion problems after hip arthroplasty. METHODS: A systematic literature review was performed through Medline, EMBASE, Scopus CINAHL, and the Cochrane Library without time restriction using search terms related to THA, SRA, US, CT, MRI, adverse tissue reactions, and corrosion. Inclusion criteria were Level I through IV studies in the English language, whereas expert opinions and case reports were excluded. The quality of included studies was judged by their level of evidence, method of intervention allocation, outcome assessments, and followup of patients. Four hundred ninety unique results were returned and 40 articles were reviewed. RESULTS: The prevalence of adverse local tissue reactions in both asymptomatic and symptomatic patients varies based on the method of evaluation (US, CT, MRI) and imaging protocols. US is accessible and relatively inexpensive, yet has not been used to report synovial thicknesses in the setting of wear-related corrosion. CT scans are highly sensitive and provide information regarding component positioning but are limited in providing enhanced soft tissue contrast and require ionizing radiation. MRI has shown promise in predicting both the presence and severity of adverse local tissue reactions but is more expensive. CONCLUSIONS: All three imaging modalities have a role in the assessment of adverse local tissue reactions and tribocorrosion after total hip arthroplasty. Although US may serve as a screening technique for the detection of larger periprosthetic collections, only MRI has been shown to predict the severity of tissue destruction found at revision and correlate to the degree of tissue necrosis at histologic evaluation.
File Format	HTM / HTML
ISSN	0009921X
e-ISSN	15281132
DOI	10.1007/s11999-014-3579-9
Journal	Clinical Orthopaedics and Related Researchtextregistered
Issue Number	12
Volume Number	472
Language	English
Publisher	Springer
Publisher Date	2014-12-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopaedics Arthroplasty, Replacement, Hip Instrumentation Diagnostic Imaging Foreign-body Reaction Diagnosis Hip Joint Surgery Hip Prosthesis Magnetic Resonance Imaging Prosthesis Failure Tomography, X-ray Computed Adverse Effects Biomechanical Phenomena Corrosion Etiology Pathology Physiopathology Metal-on-metal Joint Prostheses Predictive Value Of Tests Prosthesis Design Risk Factors Stress, Mechanical Ultrasonography
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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