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Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning

BACKGROUND AND PURPOSE: Adverse reactions to metal debris have been reported to be a cause of pain in metal-on-metal hip arthroplasty. We assessed the incidence of both symptomatic and asymptomatic adverse reactions in a consecutive series of patients with a modern large-head metal-on-metal hip arth...

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Autores principales: Wynn-Jones, Henry, Macnair, Rory, Wimhurst, James, Chirodian, Nish, Derbyshire, Brian, Toms, Andoni, Cahir, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235307/
https://www.ncbi.nlm.nih.gov/pubmed/21504335
http://dx.doi.org/10.3109/17453674.2011.579518
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author Wynn-Jones, Henry
Macnair, Rory
Wimhurst, James
Chirodian, Nish
Derbyshire, Brian
Toms, Andoni
Cahir, John
author_facet Wynn-Jones, Henry
Macnair, Rory
Wimhurst, James
Chirodian, Nish
Derbyshire, Brian
Toms, Andoni
Cahir, John
author_sort Wynn-Jones, Henry
collection PubMed
description BACKGROUND AND PURPOSE: Adverse reactions to metal debris have been reported to be a cause of pain in metal-on-metal hip arthroplasty. We assessed the incidence of both symptomatic and asymptomatic adverse reactions in a consecutive series of patients with a modern large-head metal-on-metal hip arthroplasty. METHODS: We studied the early clinical results and results of routine metal artifact-reduction MRI screening in a series of 79 large-head metal-on-metal hip arthroplasties (ASR; DePuy, Leeds, UK) in 68 patients. 75 hips were MRI scanned at mean 31 (12–52) months after surgery. RESULTS: 27 of 75 hips had MRI-detected metal debris-related abnormalities, of which 5 were mild, 18 moderate, and 4 severe. 8 of these hips have been revised, 6 of which were revised for an adverse reaction to metal debris, diagnosed preoperatively with MRI and confirmed histologically. The mean Oxford hip score (OHS) for the whole cohort was 21. It was mean 23 for patients with no MRI-based evidence of adverse reactions and 19 for those with adverse reactions detected by MRI. 6 of 12 patients with a best possible OHS of 12 had MRI-based evidence of an adverse reaction. INTERPRETATION: We have found a high early revision rate with a modern, large-head metal-on-metal hip arthroplasty. MRI-detected adverse rections to metal debris was common and often clinically “silent”. We recommend that patients with this implant should be closely followed up and undergo routine metal artifact-reduction MRI screening.
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spelling pubmed-32353072011-12-16 Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning Wynn-Jones, Henry Macnair, Rory Wimhurst, James Chirodian, Nish Derbyshire, Brian Toms, Andoni Cahir, John Acta Orthop Article BACKGROUND AND PURPOSE: Adverse reactions to metal debris have been reported to be a cause of pain in metal-on-metal hip arthroplasty. We assessed the incidence of both symptomatic and asymptomatic adverse reactions in a consecutive series of patients with a modern large-head metal-on-metal hip arthroplasty. METHODS: We studied the early clinical results and results of routine metal artifact-reduction MRI screening in a series of 79 large-head metal-on-metal hip arthroplasties (ASR; DePuy, Leeds, UK) in 68 patients. 75 hips were MRI scanned at mean 31 (12–52) months after surgery. RESULTS: 27 of 75 hips had MRI-detected metal debris-related abnormalities, of which 5 were mild, 18 moderate, and 4 severe. 8 of these hips have been revised, 6 of which were revised for an adverse reaction to metal debris, diagnosed preoperatively with MRI and confirmed histologically. The mean Oxford hip score (OHS) for the whole cohort was 21. It was mean 23 for patients with no MRI-based evidence of adverse reactions and 19 for those with adverse reactions detected by MRI. 6 of 12 patients with a best possible OHS of 12 had MRI-based evidence of an adverse reaction. INTERPRETATION: We have found a high early revision rate with a modern, large-head metal-on-metal hip arthroplasty. MRI-detected adverse rections to metal debris was common and often clinically “silent”. We recommend that patients with this implant should be closely followed up and undergo routine metal artifact-reduction MRI screening. Informa Healthcare 2011-06 2011-07-08 /pmc/articles/PMC3235307/ /pubmed/21504335 http://dx.doi.org/10.3109/17453674.2011.579518 Text en Copyright: © Nordic Orthopaedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Article
Wynn-Jones, Henry
Macnair, Rory
Wimhurst, James
Chirodian, Nish
Derbyshire, Brian
Toms, Andoni
Cahir, John
Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title_full Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title_fullStr Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title_full_unstemmed Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title_short Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning
title_sort silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: early detection with routine metal artifact-reduction mri scanning
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235307/
https://www.ncbi.nlm.nih.gov/pubmed/21504335
http://dx.doi.org/10.3109/17453674.2011.579518
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