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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-07-2014 | Hip Arthroplasty

MRI does not detect acetabular osteolysis around metal-on-metal Birmingham THA

Authors: Wenzel Waldstein, Tom Schmidt-Braekling, Friedrich Boettner

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2014

Abstract

Objective

Osteolysis has not been recognized as a common failure mode of the Birmingham modular metal-on-metal (MoM) total hip arthroplasty (THA). The clinical value of metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) to assess the periprosthetic soft tissue is well documented; however, the appropriate image modalities to detect periacetabular osteolysis remain unclear.

Case summary

Eleven patients with periacetabular osteolysis within 3–6 years after uncemented Birmingham modular MoM THA with a synergy stem are presented. All 11 patients received corresponding standardized AP pelvis radiographs, high-quality MARS MRIs and CT scans with a metal artifact reduction sequence. While periacetabular osteolysis around MoM THA was not detected on MARS MRI in ten patients, CT imaging identified osteolysis in all patients. Periacetabular osteolysis appears to be a failure mechanism of the Smith & Nephew Birmingham MoM THA.

Discussion

There is no evidence in the literature to support the effectiveness of MARS MRI to detect periacetabular osteolysis around cobalt chromium alloy metal-on-metal total hip arthroplasties. Osteolysis due to corrosion-related particles seems to be one of the primary modes of failure in modular MoM THA.

Conclusions

MRI is not a sensitive test to identify periacetabular osteolysis. The authors recommend CT for the screening of implants with this failure mode. Our study suggests that patients with a Birmingham modular MoM THA are at increased risk to develop acetabular osteolysis and should be carefully monitored for this failure mode.

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Title: MRI does not detect acetabular osteolysis around metal-on-metal Birmingham THA
Authors: Wenzel Waldstein
Tom Schmidt-Braekling
Friedrich Boettner
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-2005-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI does not detect acetabular osteolysis around metal-on-metal Birmingham THA

Abstract

Objective

Case summary

Discussion

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Case summary

Discussion

Conclusions

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