Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-02-2015 | Original Article

Magnetic resonance imaging of painful metal-on-metal total hip replacement

Authors: Vassilios S. Nikolaou, Alain Petit, Viviane Khoury, Etienne Blain-Pare, David J. Zukor, Olga L. Huk, John Antoniou

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2015

Abstract

Consecutive patients that had primary metal-on-metal (MoM) or metal-on-polyethylene (MoP) hip arthroplasty were prospectively enrolled to this study. All operated hips were evaluated with MRI by one radiologist who was blinded to the radiographic findings and clinical symptoms. Three groups of patients were formed: (1) thirteen MoM THRs in 13 patients with groin pain (Group 1), (2) ten MoM THRs in 10 patients with no pain (Group 2), (3) five MoP THRs in 4 patients without pain (control group). Abnormal MRI findings were distributed in all groups in a balanced way, irrespective of the patients’ symptoms, prostheses, or metal ion levels. Two patients from Group 1 and one patient of Group 3 (control group) were diagnosed with a large periprosthetic mass (pseudotumor).

Weber BG (1992) Metal-metal total prosthesis of the hip joint: back to the future. Z Orthop Ihre Grenzgeb 130:306–309PubMedCrossRef

Czerny C, Krestan C, Imhof H, Trattnig S (1999) Magnetic resonance imaging of the postoperative hip. Top Magn Reson Imaging 10:214–220PubMedCrossRef

Potter HG, Nestor BJ, Sofka CM, Ho ST, Peters LE, Salvati V (2004) Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue. J Bone Joint Surg Am 86A:1947–1954

White LM, Kim JK, Mehta M, Merchant N, Schweitzer ME, Morrison WB, Hutchison CR, Gross AE (2000) Complications of total hip arthroplasty: MR imaging-initial experience. Radiology 215:254–262PubMedCrossRef

Pfirrmann CW, Notzli HP, Dora C, Hodler J, Zanetti M (2005) Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology 235:969–976PubMedCrossRef

Suh JS, Jeong EK, Shin KH, Cho JH, Na JB, Kim DH, Han CD (1998) Minimizing artifacts caused by metallic implants at MR imaging: experimental and clinical studies. AJR Am J Roentgenol 171:1207–1213PubMedCrossRef

Mistry A, Cahir J, Donell ST, Nolan J, Toms AP (2011) MRI of asymptomatic patients with metal-on-metal and polyethylene-on-metal total hip arthroplasties. Clin Radiol 66:540–545PubMedCrossRef

Cooper HJ, Ranawat AS, Potter HG, Foo LF, Jawetz ST, Ranawat CS (2009) Magnetic resonance imaging in the diagnosis and management of hip pain after total hip arthroplasty. J Arthroplasty 24:661–667PubMedCrossRef

Toms AP, Marshall TJ, Cahir J, Darrah C, Nolan J, Donell ST, Barker T, Tucker JK (2008) MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips. Clin Radiol 63:49–58PubMedCrossRef

10.

Hallab N, Jacobs JJ, Black J (2000) Hypersensitivity to metallic biomaterials: a review of leukocyte migration inhibition assays. Biomaterials 21:1301–1314PubMedCrossRef

11.

Gawkrodger DJ (2003) Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol 148:1089–1093PubMedCrossRef

12.

Willert HG, Buchhorn GH, Fayyazi A, Flury R, Windler M, Koster G, Lohmann CH (2005) Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am 87:28–36PubMedCrossRef

13.

MacDonald SJ (2004) Can a safe level for metal ions in patients with metal-on-metal total hip arthroplasties be determined? J Arthroplasty 19:71–77PubMedCrossRef

14.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed

15.

Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC (1998) Assessing activity in joint replacement patients. J Arthroplasty 13:890–895PubMedCrossRef

16.

Antoniou J, Zukor DJ, Mwale F, Minarik W, Petit A, Huk OL (2008) Metal ion levels in the blood of patients after hip resurfacing: a comparison between twenty-eight and thirty-six-millimeter-head metal-on-metal prostheses. J Bone Joint Surg Am 90(Suppl 3):142–148PubMedCrossRef

17.

Bernstein V, Gupta S, Petit A, Zukor DJ, Huk OL, Antoniou J (2011) The effect of operative factors on outlier ion levels in patients with metal-on-metal hip arthroplasties. Bull NYU Hosp Jt Dis 69(Suppl 1):S20–s26PubMed

18.

Britton AR, Murray DW, Bulstrode CJ, McPherson K, Denham RA (1997) Pain levels after total hip replacement: their use as endpoints for survival analysis. J Bone Joint Surg Br 79:93–98PubMedCrossRef

19.

Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CL, Ostlere S, Athanasou N, Gill HS, Murray DW (2008) Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 90:847–851PubMedCrossRef

20.

Campbell P, Shimmin A, Walter L, Solomon M (2008) Metal sensitivity as a cause of groin pain in metal-on-metal hip resurfacing. J Arthroplasty 23:1080–1085PubMedCrossRef

21.

Hart AJ, Sabah S, Henckel J, Lewis A, Cobb J, Sampson B, Mitchell A, Skinner JA (2009) The painful metal-on-metal hip resurfacing. J Bone Joint Surg Br 91:738–744PubMedCrossRef

22.

Johnston C, Kerr J, Ford S, O’Byrne J, Eustace S (2007) MRI as a problem-solving tool in unexplained failed total hip replacement following conventional assessment. Skeletal Radiol 36:955–961PubMedCrossRef

23.

Cahir JG, Toms AP, Marshall TJ, Wimhurst J, Nolan J (2007) CT and MRI of hip arthroplasty. Clin Radiol 62: 1163–1171; discussion 1172–1163

24.

Kwon YM, Ostlere SJ, McLardy-Smith P, Athanasou NA, Gill HS, Murray DW (2011) “Asymptomatic” pseudotumors after metal-on-metal hip resurfacing arthroplasty: prevalence and metal ion study. J Arthroplasty 26:511–518PubMedCrossRef

25.

Sabah SA, Mitchell AW, Henckel J, Sandison A, Skinner JA, Hart AJ (2011) Magnetic resonance imaging findings in painful metal-on-metal hips: a prospective study. J Arthroplasty 26: 71–76, 76 e71–72

26.

Fehring TK, Odum S, Sproul R, Weathersbee J (2014) High frequency of adverse local tissue reactions in asymptomatic patients with metal-on-metal THA. Clin Orthop Relat Res 472(2):517–522

27.

Nawabi DH, Hayter CL, Su EP, Koff MF, Perino G, Gold SL, Koch KM, Potter HG (2013) Magnetic resonance imaging findings in symptomatic versus asymptomatic subjects following metal-on-metal hip resurfacing arthroplasty. J Bone Joint Surg Am 95:895–902PubMedCrossRef

28.

Chang EY, McAnally JL, Van Horne JR, Statum S, Wolfson T, Gamst A, Chung CB (2012) Metal-on-metal total hip arthroplasty: do symptoms correlate with MR imaging findings? Radiology 265:848–857PubMedCrossRef

29.

Leigh W, O’Grady P, Lawson EM, Hung NA, Theis JC, Matheson J (2008) Pelvic pseudotumor: an unusual presentation of an extra-articular granuloma in a well-fixed total hip arthroplasty. J Arthroplasty 23:934–938PubMedCrossRef

30.

Svensson O, Mathiesen EB, Reinholt FP, Blomgren G (1988) Formation of a fulminant soft-tissue pseudotumor after uncemented hip arthroplasty. A case report. J Bone Joint Surg Am 70:1238–1242PubMed

31.

Scully WF, Teeny SM (2013) Pseudotumor associated with metal-on-polyethylene total hip arthroplasty. Orthopedics 36:e666–e670PubMedCrossRef

Title: Magnetic resonance imaging of painful metal-on-metal total hip replacement
Authors: Vassilios S. Nikolaou
Alain Petit
Viviane Khoury
Etienne Blain-Pare
David J. Zukor
Olga L. Huk
John Antoniou
Publication date: 01-02-2015
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2015
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-014-1491-3

At a glance: The STEP trials

Springer Medicine

Magnetic resonance imaging of painful metal-on-metal total hip replacement

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2015

Patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction: a systematic review and meta-analysis

A new joystick technique for unsuccessful closed reduction of supracondylar humeral fractures: minimum trauma

Role of radiotherapy in the management of heel spur

Influence of the volume of bone defect, bone grafting methods, and hook fixation on stress on the Kerboull-type plate and screw in total hip arthroplasty: three-dimensional finite element analysis

Load transmission characteristics of limited carpal fusions: a two-dimensional finite element study

Functional outcome and quality of life after rehabilitation for voluntary posterior shoulder dislocation: a prospective blinded cohort study