Document Detail


Early reactive synovitis and osteolysis after total hip arthroplasty.
MedLine Citation:
PMID:  20419484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about intraarticular pathology following THA prior to the radiographic appearance of osteolysis, primarily due to imaging limitations. MRI has recently been applied to imaging the postarthroplasty hip with the ability to detect periarticular bony and soft tissue pathology; specifically, it is able to detect abnormal synovial patterns and focal bone loss well before the radiographic appearance of osteolysis.
QUESTIONS/PURPOSES: We therefore used MRI to determine the incidence of early reactive synovitis and osteolysis in asymptomatic patients after THA, and whether there is an association between these MRI findings and clinical outcomes or radiographic wear measurements at this early stage.
METHODS: We recruited 31 patients (33 hips) who underwent routine noncemented THA with one of three types of bearing surfaces: metal-on-cross-linked polyethylene (n = 7), ceramic-on-ceramic (n = 12), and ceramic-on-cross-linked polyethylene (n = 14). Patients underwent specialized MRI at a minimum of 12 months (mean, 23 months; range, 12-37 months) after surgery. MR images were analyzed for the presence of synovitis or osteolysis. WOMAC scores, patient assessment questionnaires, and radiographic wear measurements were correlated with MRI findings.
RESULTS: Reactive synovitis was observed in 13 of 33 patients (39%) and focal osteolysis in one of 33 (3%). The presence of synovitis did not correlate with pain, activity level, patient satisfaction or clinical outcome scales, nor did it correlate with radiographic wear measurements at early followup.
CONCLUSIONS: Our observations suggest reactive synovitis is common yet asymptomatic at short-term followup. We do not know either the etiology or the long-term implications of these observations.
Authors:
H John Cooper; Amar S Ranawat; Hollis G Potter; Li Foong Foo; Trevor W Koob; Chitranjan S Ranawat
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-06     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3278-85     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Lenox Hill Hospital, William Black Hall, 11th Floor, 130 East 77th Street, New York, NY 10075, USA. jcooper02@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arthroplasty, Replacement, Hip / adverse effects*,  instrumentation
Chi-Square Distribution
Female
Hip Joint / pathology,  physiopathology,  radiography,  surgery*
Hip Prosthesis
Humans
Magnetic Resonance Imaging
Male
Middle Aged
New York City
Osteolysis / etiology*,  pathology,  physiopathology,  radiography
Prosthesis Design
Questionnaires
Recovery of Function
Retrospective Studies
Synovitis / etiology*,  pathology,  physiopathology,  radiography
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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