What Is the Clinical Presentation of Adverse Local Tissue Reaction in Metal-on-metal Hip Arthroplasty? An MRI Study

Clinical Orthopaedics and Related Research
Vincent P GaleaHenrik Malchau

Abstract

Adverse local tissue reaction (ALTR) is not only a prominent cause of metal-on-metal (MoM) implant revision, but may also compromise the result of revision surgery. Patients treated with MoM arthroplasty and subsequently revised as a result of ALTR have been shown to experience worse patient-reported outcomes, inferior survivorship, and more complications when compared with patients receiving MoM implants who were revised for reasons other than ALTR. There is conflicting evidence as to whether the presence of symptoms is associated with ALTR in patients with MoM implants. Blood metal ions are associated with ALTR, but a consensus on appropriate thresholds associated with ALTR risk is lacking. (1) Was the presence of symptoms as measured by patient-reported outcome measures associated with ALTR presence and severity as noted on metal artifact reduction sequence (MARS)-MRI in patients treated with one design of MoM THA or hip resurfacing arthroplasty (HRA)? (2) Could reliable thresholds for blood metal ion levels be determined that were associated with ALTR presence on MARS-MRI? This retrospective study presents a secondary analysis of data drawn from a prospective, international, multicenter study of the recalled Articular Surfa...Continue Reading

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Citations

Dec 4, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Nicola BozzaClaudio C Castelli
Jan 7, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Guillaume-Anthony OdriPascal Bizot
Apr 11, 2021·Archives of Orthopaedic and Trauma Surgery·Christian KlemtYoung-Min Kwon

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