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. 2021 Oct 15;29(20):e1025-e1033.
doi: 10.5435/JAAOS-D-20-00793.

MRI Characteristics of Adverse Local Tissue Reactions Associated With Intraoperative Tissue Damage and Poor Revision Surgery Outcomes: A Systematic Review

Liang Xiong  1 , Evan J Smith, Christian Klemt, Ameen Barghi, Anand Padmanabha, Young-Min Kwon
Affiliations

MRI Characteristics of Adverse Local Tissue Reactions Associated With Intraoperative Tissue Damage and Poor Revision Surgery Outcomes: A Systematic Review

Liang Xiong et al. J Am Acad Orthop Surg. .

Abstract

Background: Metal artifact reductions sequence (MARS) MRI has been established as a cross-sectional imaging modality for diagnosis of adverse local tissue reaction (ALTR). This study aims to evaluate the current literature regarding the characteristics of MARS MRI associated with intraoperative tissue necrosis and postoperative complications in patients undergoing revision THA because of ALTR.

Methods: We systematically searched the literature that included reporting MRI characteristics of ALTR in failed THA and their correlation with intraoperative findings and postoperative outcomes.

Results: A total of 617 studies were assessed, and 15 studies met the inclusion criteria. Synovial wall thickness correlated with increasing ALVAL grade, however, weakly with tissue necrosis. Synovial composition of mixed or solid features and the presence of abductor disruption correlated with complications and tissue necrosis. Tissue edema was a poor predictor of aseptic lymphocyte-dominant vasculitis-associated lesion (ALVAL) grade or tissue necrosis.

Discussion: MARS MRI synovial composition including mixed and solid features and the presence of abductor disruption provide the best prognostic characteristics associated with intraoperative soft-tissue necrosis and revision surgery outcome. These prognostic characteristics on MRI may assist surgeons with improved criteria for intervention and preoperative patient counseling.

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References

    1. Mahendra G, Pandit H, Kliskey K, Murray D, Gill HS, Athanasou N: Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties. Acta Orthop 2009;80:653-659.
    1. Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AVF: Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: A consequence of excess wear. J Bone Joint Surg Br 2010;92:38-46.
    1. Pandit H, Glyn-Jones S, McLardy-Smith P, et al.: Pseudotumours associated with metal-on-metal hip resurfacings. J Bone Joint Surg Br 2008;90:847-851.
    1. Plummer DR, Berger RA, Paprosky WG, Sporer SM, Jacobs JJ, Della Valle CJ: Diagnosis and management of adverse local tissue reactions secondary to corrosion at the head-neck junction in patients with metal on polyethylene bearings. J Arthroplasty 2016;31:264-268.
    1. Hauptfleisch J, Pandit H, Grammatopoulos G, Gill HS, Murray DW, Ostlere S: A MRI classification of periprosthetic soft tissue masses (pseudotumours) associated with metal-on-metal resurfacing hip arthroplasty. Skeletal Radiol 2012;41:149-155.

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