Alissa J. Burge1, Danyal H. Nawabi2, Stephanie Gold1, Stephen Lyman3, Douglas E. Padgett2, Matthew F. Koff1, Hollis G. Potter1
1Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States; 2Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, United States; 3Division of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY, United States
An MRI classification system was developed to predict adverse local tissue reactions (ALTRs) in patients with metal-on-metal hip arthroplasty. MR images from 70 patients were assessed for osteolysis, synovitis, synovial thickness, presence of edema, synovial decompression, low signal intensity deposits, pseudocapsule dehiscence, disrupted abductors and neurovascular compression. Synovial tissues were obtained intra-operatively and were graded to assess tissue reaction. The presence and volume of synovitis, and the synovial thickness were found to correlate with histologic scoring. In patients with failed metal-on-metal (MOM) hip arthroplasty, MRI can be used to identify an adverse tissue reaction and predict the presence of soft tissue damage, helping guide the need for revision.