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MRI Findings Associated with Recalled Modular Femoral Neck Rejuvenate and ABG Implants
Christopher P Walsh1, James C Hubbard2, Joseph P Nessler3
1Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan.
Abstract:
MARS-MRI is suggested for the diagnosis of adverse local tissue reactions (ALTR) in patients with recalled femoral stems with modular necks, but there has been no major study looking at MARS-MRI findings in this population. A retrospective review was performed on 312 patients who received a modular neck hip implant between October 2007 and February 2012. 62% of patients had intra-articular effusions, with 27% containing debris. Extra-capsular effusions were present in 35% of hips. 54% had synovitis and 5.4% had osteolysis. Tendinopathy and tendon disruption was present in the gluteus medius (58%/12%), hamstring (56%/12%), gluteus minimus (38%/7.7%) and iliopsoas (7.1%/4.8%). Abnormal MARS-MRI findings are associated with modular neck femoral components and can suggest underlying ALTR. MARS-MRI abnormalities merit serious consideration in this population.
Insights
Magnetic Resonance Arthrography with specific sequences (MARS-MRI) can help diagnose adverse local tissue reactions (ALTR) in patients with recalled hip implants. Abnormal findings on MARS-MRI are linked to these hip implants and suggest potential ALTR.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomaterials Science
Background:
- Recalled femoral stems with modular necks pose a risk for adverse local tissue reactions (ALTR).
- Magnetic Resonance Arthrography with specific sequences (MARS-MRI) is a potential diagnostic tool for ALTR.
- Limited research exists on MARS-MRI findings in patients with recalled modular neck hip implants.
Purpose of the Study:
- To investigate the prevalence and characteristics of MARS-MRI findings in patients with recalled femoral stems and modular necks.
- To assess the association between MARS-MRI abnormalities and adverse local tissue reactions (ALTR) in this specific patient cohort.
Main Methods:
- Retrospective review of 312 patients who received modular neck hip implants between October 2007 and February 2012.
- Analysis of MARS-MRI scans to identify intra-articular and extra-capsular effusions, synovitis, osteolysis, and tendinopathy.
- Correlation of imaging findings with clinical outcomes related to ALTR.
Main Results:
- 62% of patients exhibited intra-articular effusions, with 27% containing debris.
- Extra-capsular effusions were observed in 35% of hips.
- Synovitis (54%) and osteolysis (5.4%) were noted. High rates of tendinopathy and tendon disruption were found in the gluteus medius, hamstring, gluteus minimus, and iliopsoas tendons.
Conclusions:
- Abnormal MARS-MRI findings are frequently observed in patients with modular neck femoral components.
- MARS-MRI abnormalities are associated with adverse local tissue reactions (ALTR) in this population.
- MARS-MRI findings warrant significant consideration for diagnosing ALTR in patients with recalled modular neck hip implants.
