Comparison of Asymptomatic and Symptomatic Adverse Local Tissue Reaction in Patients With Head-Neck Taper Corrosion
| Autor: | Kenneth L. Urish, Camilo Borrero, Brian R. Hamlin, Deepak Kumar, Anthony M. DiGioia, Kalain K. Workman, Matthew J. Snyder, Anton Plakseychuk, Margaret A. Weber, Akshay V. Daji, Clair N. Smith, Margaret M. Sims, Andrew C. Cordle |
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| Rok vydání: | 2021 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty Mars mri Bursitis medicine.diagnostic_test business.industry Magnetic resonance imaging medicine.disease Asymptomatic 03 medical and health sciences 0302 clinical medicine Cohort medicine Orthopedics and Sports Medicine Radiology Implant medicine.symptom business Taper corrosion Total hip arthroplasty |
| Zdroj: | The Journal of Arthroplasty. 36:S358-S362 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2020.09.014 |
| Popis: | Background Diagnosis of adverse local tissue reaction (ALTR) in metal-on-polyethylene (MoP) total hip arthroplasty (THA) secondary to head-neck taper corrosion is challenging. The purpose of this study is to compare differences between asymptomatic and symptomatic ALTR in an observational cohort, including presentation, metal ion differences, and metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) findings. Methods We performed a retrospective review of an observational cohort of 492 MoP THA patients at increased risk of developing ALTR. Ninety-four patients underwent revision arthroplasty for ALTR. Patients were stratified into symptomatic and asymptomatic ALTR groups. Presentation, metal ion levels, and imaging findings were compared. Results For patients with confirmed ALTR, 41% were asymptomatic. There was a statistically significant difference in the serum chromium levels between symptomatic and asymptomatic ALTR patients (2.2 μg/L vs 3.1 μg/L, P = .05). There was no statistically significant difference between the serum cobalt levels or MRI findings in these 2 groups. We observed that extracapsular disease associated with ALTR could be misinterpreted as trochanteric bursitis. Conclusion Almost half of the MoP THA ALTR cases identified were asymptomatic. Cobalt levels could not differentiate between symptomatic and asymptomatic pseudotumor formation. Symptomatic and asymptomatic MoP ALTRs have similar MARS MRI characteristics. Our findings suggest that it is essential to risk stratify patients who could potentially have ALTR based on implant type, symptoms, ion levels, and MARS MRI. |
| Databáze: | OpenAIRE |
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