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MR imaging after hip and knee replacement.

Sebastian Koch1, Alejandro Forteza, Carlos Lavernia

  • 1Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. skoch@med.miami.edu

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|September 27, 2007
PubMed
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Intraoperative microembolism is common during hip and knee replacement surgery. However, diffusion-weighted (DW) imaging shows no acute abnormalities after these procedures, indicating safety.

Area of Science:

  • Neurology
  • Radiology
  • Orthopedic Surgery

Background:

  • Invasive procedures, including orthopedic surgery, can cause cerebral microembolism.
  • Diffusion-weighted (DW) imaging abnormalities are often seen after procedures linked to cerebral microembolism.

Purpose of the Study:

  • To investigate the impact of intraoperative microembolism on acute magnetic resonance (MR) imaging in patients undergoing hip and knee replacement.

Main Methods:

  • 24 patients aged 65+ undergoing elective hip or knee replacement were enrolled.
  • Pre- and postoperative MR imaging, including DW and FLAIR sequences, was performed.
  • Intraoperative monitoring for microemboli was conducted.

Main Results:

  • All patients experienced intraoperative microemboli (mean 9.9 +/- 18 per surgery).

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  • Postoperative MR imaging, obtained a mean of 3.5 days later, revealed no DW imaging abnormalities.
  • One patient showed new findings on postoperative FLAIR imaging.

    • Conclusions:

    • Universal intraoperative microembolism occurred in hip and knee replacement patients.
    • No acute DW imaging abnormalities were detected post-surgery.
    • FLAIR imaging abnormalities are rare but possible after joint replacement surgery.