Download PDF
Semin Musculoskelet Radiol 2013; 17(03): 316-327
DOI: 10.1055/s-0033-1348098
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of Hip Arthroplasty

Jan Fritz
1   Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York
,
Brett Lurie
1   Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York
,
Theodore T. Miller
1   Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
20 June 2013 (online)

Also available at
   Permissions and Reprints

Abstract

Imaging studies are central to the evaluation of persistent or recurrent symptoms after hip arthroplasty. The evaluation starts with radiographs and may be followed by arthrography, aspiration, scintigraphy, sonography, computed tomography, and MR imaging. Common etiologies of a painful or dysfunctional hip arthroplasty are mechanical loosening, polyethylene wear–induced osteolysis, adverse local tissue reaction to metal wear products, infection, fractures, heterotopic ossification, tendinopathy, and nerve injury. MR imaging with optimized protocols and dedicated techniques for metal artifact reduction is the most comprehensive imaging modality. In this article, we discuss and illustrate the imaging appearances of these conditions with a focus on the MR imaging evaluation.

Keywords

hip - arthroplasty - ALVAL - adverse tissue reaction - MR imaging
 

  • References

  • 1 Mancuso CA, Salvati EA, Johanson NA, Peterson MG, Charlson ME. Patients' expectations and satisfaction with total hip arthroplasty. J Arthroplasty 1997; 12 (4) 387-396
    CrossrefPubMedGoogle Scholar
  • 2 Brown TE, Larson B, Shen F, Moskal JT. Thigh pain after cementless total hip arthroplasty: evaluation and management. J Am Acad Orthop Surg 2002; 10 (6) 385-392
    CrossrefPubMedGoogle Scholar
  • 3 Miller TT. Sonography of joint replacements. Semin Musculoskelet Radiol 2006; 10 (1) 79-85
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Lee MJ, Kim S, Lee SA , et al. Overcoming artifacts from metallic orthopedic implants at high-field-strength MR imaging and multi-detector CT. Radiographics 2007; 27 (3) 791-803
    CrossrefPubMedGoogle Scholar
  • 5 Fritz J, Fishman EK, Corl F, Carrino JA, Weber KL, Fayad LM. Imaging of limb salvage surgery. AJR Am J Roentgenol 2012; 198 (3) 647-660
    CrossrefPubMedGoogle Scholar
  • 6 Bamberg F, Dierks A, Nikolaou K, Reiser MF, Becker CR, Johnson TR. Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. Eur Radiol 2011; 21 (7) 1424-1429
    CrossrefPubMedGoogle Scholar
  • 7 Pessis E, Campagna R, Sverzut JM , et al. Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics 2013; 33 (2) 573-583
    CrossrefPubMedGoogle Scholar
  • 8 Meinel FG, Bischoff B, Zhang Q, Bamberg F, Reiser MF, Johnson TR. Metal artifact reduction by dual-energy computed tomography using energetic extrapolation: a systematically optimized protocol. Invest Radiol 2012; 47 (7) 406-414
    CrossrefPubMedGoogle Scholar
  • 9 Potter HG, Foo LF. Magnetic resonance imaging of joint arthroplasty. Orthop Clin North Am 2006; 37 (3) 361-373 , vi–vii
    CrossrefPubMedGoogle Scholar
  • 10 U.S. Food and Drug Administration. Information about soft tissue imaging and metal ion testing. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/MetalonMetalHipImplants/ucm331971.htm . Accessed March 11, 2013
    PubMedGoogle Scholar
  • 11 Hayter CL, Koff MF, Shah P, Koch KM, Miller TT, Potter HG. MRI after arthroplasty: comparison of MAVRIC and conventional fast spin-echo techniques. AJR Am J Roentgenol 2011; 197 (3) W405-W411
    CrossrefPubMedGoogle Scholar
  • 12 Koch KM, Lorbiecki JE, Hinks RS, King KF. A multispectral three-dimensional acquisition technique for imaging near metal implants. Magn Reson Med 2009; 61 (2) 381-390
    CrossrefPubMedGoogle Scholar
  • 13 D'Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell Jr CW. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 2000; 82 (3) 315-321
    PubMedGoogle Scholar
  • 14 Barrack RL, Lavernia C, Ries M, Thornberry R, Tozakoglou E. Virtual reality computer animation of the effect of component position and design on stability after total hip arthroplasty. Orthop Clin North Am 2001; 32 (4) 569-577 , vii
    CrossrefPubMedGoogle Scholar
  • 15 Barrack RL. Dislocation after total hip arthroplasty: implant design and orientation. J Am Acad Orthop Surg 2003; 11 (2) 89-99
    PubMedGoogle Scholar
  • 16 Miller TT. Imaging of hip arthroplasty. Semin Musculoskelet Radiol 2006; 10 (1) 30-46
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 De Haan R, Pattyn C, Gill HS, Murray DW, Campbell PA, De Smet K. Correlation between inclination of the acetabular component and metal ion levels in metal-on-metal hip resurfacing replacement. J Bone Joint Surg Br 2008; 90 (10) 1291-1297
    PubMedGoogle Scholar
  • 18 De Haan R, Campbell PA, Su EP, De Smet KA. Revision of metal-on-metal resurfacing arthroplasty of the hip: the influence of malpositioning of the components. J Bone Joint Surg Br 2008; 90 (9) 1158-1163
    PubMedGoogle Scholar
  • 19 Morscher EW. Cementless total hip arthroplasty. Clin Orthop Relat Res 1983; (181) 76-91
    PubMedGoogle Scholar
  • 20 Moore MS, McAuley JP, Young AM, Engh Sr CA. Radiographic signs of osseointegration in porous-coated acetabular components. Clin Orthop Relat Res 2006; 444: 176-183
    PubMedGoogle Scholar
  • 21 Lindahl H, Garellick G, Regnér H, Herberts P, Malchau H. Three hundred and twenty-one periprosthetic femoral fractures. J Bone Joint Surg Am 2006; 88 (6) 1215-1222
    CrossrefPubMedGoogle Scholar
  • 22 Goldring SR, Schiller AL, Roelke M, Rourke CM, O'Neil DA, Harris WH. The synovial-like membrane at the bone-cement interface in loose total hip replacements and its proposed role in bone lysis. J Bone Joint Surg Am 1983; 65 (5) 575-584
    CrossrefPubMedGoogle Scholar
  • 23 Bosetti M, Massè A, Navone R, Cannas M. Biochemical and histological evaluation of human synovial-like membrane around failed total hip replacement prostheses during in vitro mechanical loading. J Mater Sci Mater Med 2001; 12 (8) 693-698
    CrossrefPubMedGoogle Scholar
  • 24 Berger R, Fletcher F, Donaldson T, Wasielewski R, Peterson M, Rubash H. Dynamic test to diagnose loose uncemented femoral total hip components. Clin Orthop Relat Res 1996; (330) 115-123
    PubMedGoogle Scholar
  • 25 Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; (141) 17-27
    PubMedGoogle Scholar
  • 26 DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976; (121) 20-32
    PubMedGoogle Scholar
  • 27 Engh Jr CA, McAuley JP, Sychterz CJ, Sacco ME, Engh Sr CA. The accuracy and reproducibility of radiographic assessment of stress-shielding. A postmortem analysis. J Bone Joint Surg Am 2000; 82-A (10) 1414-1420
    PubMedGoogle Scholar
  • 28 Manaster BJ. From the RSNA refresher courses. Total hip arthroplasty: radiographic evaluation. Radiographics 1996; 16 (3) 645-660
    CrossrefPubMedGoogle Scholar
  • 29 Engh CA, Griffin WL, Marx CL. Cementless acetabular components. J Bone Joint Surg Br 1990; 72 (1) 53-59
    PubMedGoogle Scholar
  • 30 Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 1990; (257) 107-128
    PubMedGoogle Scholar
  • 31 Harris WH, McCarthy Jr JC, O'Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 1982; 64 (7) 1063-1067
    PubMedGoogle Scholar
  • 32 Malchau H, Kärrholm J, Wang YX, Herberts P. Accuracy of migration analysis in hip arthroplasty. Digitized and conventional radiography, compared to radiostereometry in 51 patients. Acta Orthop Scand 1995; 66 (5) 418-424
    PubMedGoogle Scholar
  • 33 Bauer TW, Schils J. The pathology of total joint arthroplasty. II. Mechanisms of implant failure. Skeletal Radiol 1999; 28 (9) 483-497
    CrossrefPubMedGoogle Scholar
  • 34 Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty 2002; 17 (5) 649-661
    CrossrefPubMedGoogle Scholar
  • 35 McKellop HA. Bearing surfaces in total hip replacements: state of the art and future developments. Instr Course Lect 2001; 50: 165-179
    PubMedGoogle Scholar
  • 36 Baxter RM, MacDonald DW, Kurtz SM, Steinbeck MJ. Characteristics of highly cross-linked polyethylene wear debris in vivo. J Biomed Mater Res B Appl Biomater 2013; 101 (3) 467-475
    PubMedGoogle Scholar
  • 37 Maloney WJ, Galante JO, Anderson M , et al. Fixation, polyethylene wear, and pelvic osteolysis in primary total hip replacement. Clin Orthop Relat Res 1999; (369) 157-164
    PubMedGoogle Scholar
  • 38 Claus AM, Engh Jr CA, Sychterz CJ, Xenos JS, Orishimo KF, Engh Sr CA. Radiographic definition of pelvic osteolysis following total hip arthroplasty. J Bone Joint Surg Am 2003; 85-A (8) 1519-1526
    PubMedGoogle Scholar
  • 39 Walde TA, Weiland DE, Leung SB , et al. Comparison of CT, MRI, and radiographs in assessing pelvic osteolysis: a cadaveric study. Clin Orthop Relat Res 2005; (437) 138-144
    PubMedGoogle Scholar
  • 40 Schmalzried TP. Metal-metal bearing surfaces in hip arthroplasty. Orthopedics 2009; 32 (9)
    PubMedGoogle Scholar
  • 41 Amstutz HC, Le Duff MJ, Campbell PA, Wisk LE, Takamura KM. Complications after metal-on-metal hip resurfacing arthroplasty. Orthop Clin North Am 2011; 42 (2) 207-230 , viii
    CrossrefPubMedGoogle Scholar
  • 42 Huber M, Reinisch G, Trettenhahn G, Zweymüller K, Lintner F. Presence of corrosion products and hypersensitivity-associated reactions in periprosthetic tissue after aseptic loosening of total hip replacements with metal bearing surfaces. Acta Biomater 2009; 5 (1) 172-180
    CrossrefPubMedGoogle Scholar
  • 43 Campbell P, Ebramzadeh E, Nelson S, Takamura K, De Smet K, Amstutz HC. Histological features of pseudotumor-like tissues from metal-on-metal hips. Clin Orthop Relat Res 2010; 468 (9) 2321-2327
    CrossrefPubMedGoogle Scholar
  • 44 Nawabi DH, Gold S, Lyman S, Fields K, Padgett DE, Potter HG. MRI predicts ALVAL and tissue damage in metal-on-metal hip arthroplasty. Clin Orthop Relat Res 2013; ; January 26 ( Epub ahead of print)
    PubMedGoogle Scholar
  • 45 Hart AJ, Sabah SA, Bandi AS , et al. Sensitivity and specificity of blood cobalt and chromium metal ions for predicting failure of metal-on-metal hip replacement. J Bone Joint Surg Br 2011; 93 (10) 1308-1313
    PubMedGoogle Scholar
  • 46 Bauer TW, Parvizi J, Kobayashi N, Krebs V. Diagnosis of periprosthetic infection. J Bone Joint Surg Am 2006; 88 (4) 869-882
    CrossrefPubMedGoogle Scholar
  • 47 Palestro CJ, Love C, Tronco GG, Tomas MB, Rini JN. Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection. Radiographics 2006; 26 (3) 859-870
    CrossrefPubMedGoogle Scholar
  • 48 Karchevsky M, Schweitzer ME, Morrison WB, Parellada JA. MRI findings of septic arthritis and associated osteomyelitis in adults. AJR Am J Roentgenol 2004; 182 (1) 119-122
    CrossrefPubMedGoogle Scholar
  • 49 Plodkowski AJ, Hayter CL, Miller TT, Nguyen JT, Potter HG. Lamellated hyperintense synovitis: potential MR imaging sign of an infected knee arthroplasty. Radiology 2013; 266 (1) 256-260
    CrossrefPubMedGoogle Scholar
  • 50 Pike J, Davidson D, Garbuz D, Duncan CP, O'Brien PJ, Masri BA. Principles of treatment for periprosthetic femoral shaft fractures around well-fixed total hip arthroplasty. J Am Acad Orthop Surg 2009; 17 (11) 677-688
    PubMedGoogle Scholar
  • 51 Duncan CP, Masri BA. Fractures of the femur after hip replacement. Instr Course Lect 1995; 44: 293-304
    PubMedGoogle Scholar
  • 52 Pritchett JW. Fracture of the greater trochanter after hip replacement. Clin Orthop Relat Res 2001; (390) 221-226
    PubMedGoogle Scholar
  • 53 Cook SM, Pellicci PM, Potter HG. Use of magnetic resonance imaging in the diagnosis of an occult fracture of the femoral component after total hip arthroplasty. A case report. J Bone Joint Surg Am 2004; 86-A (1) 149-153
    PubMedGoogle Scholar
  • 54 Thomas BJ. Heterotopic bone formation after total hip arthroplasty. Orthop Clin North Am 1992; 23 (2) 347-358
    PubMedGoogle Scholar
  • 55 Brooker AF, Bowerman JW, Robinson RA, Riley Jr LH. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973; 55 (8) 1629-1632
    CrossrefPubMedGoogle Scholar
  • 56 Magid D. Preoperative interactive 2D-3D computed tomography assessment of heterotopic bone. Semin Arthroplasty 1992; 3 (3) 191-199
    PubMedGoogle Scholar
  • 57 Lachiewicz PF. Abductor tendon tears of the hip: evaluation and management. J Am Acad Orthop Surg 2011; 19 (7) 385-391
    PubMedGoogle Scholar
  • 58 Douis H, Dunlop DJ, Pearson AM, O'Hara JN, James SL. The role of ultrasound in the assessment of post-operative complications following hip arthroplasty. Skeletal Radiol 2012; 41 (9) 1035-1046
    CrossrefPubMedGoogle Scholar
  • 59 Connell DA, Bass C, Sykes CA, Young D, Edwards E. Sonographic evaluation of gluteus medius and minimus tendinopathy. Eur Radiol 2003; 13 (6) 1339-1347
    PubMedGoogle Scholar
  • 60 Pfirrmann CW, Notzli HP, Dora C, Hodler J, Zanetti M. Abductor tendons and muscles assessed at MR imaging after total hip arthroplasty in asymptomatic and symptomatic patients. Radiology 2005; 235 (3) 969-976
    CrossrefPubMedGoogle Scholar
  • 61 Lonner JH, Lotke PA. Aseptic complications after total knee arthroplasty. J Am Acad Orthop Surg 1999; 7 (5) 311-324
    PubMedGoogle Scholar