Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning

Adverse reactions to metal debris have been reported to be a cause of pain in metal-on-metal hip arthroplasty. We assessed the incidence of both symptomatic and asymptomatic adverse reactions in a consecutive series of patients with a modern large-head metal-on-metal hip arthroplasty

The natural history of metallosis from catastrophic failure of a polyethylene liner in a total hip

We report on a case of metallosis initially presumed to be heterotopic ossification based on radiologic findings. A 68-year-old man with a total hip arthroplasty experienced failure of the polyethylene liner, resulting in articulation of the ceramic head with the titanium acetabular shell. During revision surgery, extensive metallic debris was evident macroscopically throughout the periprosthetic tissue and was confirmed histologically to be metallosis

A reliability study of measurement tools available on standard picture archiving and communication system workstations for the evaluation of hip radiographs following arthroplasty

Conventional radiography is the primary imaging tool for routine follow-up of total hip replacements, but the reliability of this method has been questioned. The aim of this study was to assess the reliability of commonly used measurements of the position of hip prostheses on postoperative radiographs with use of tools available on all standard picture archiving and communication system workstations

A New Technique for Radiographic Measurement of Acetabular Cup Orientation

Accurate radiographic measurement of acetabular cup orientation is required in order to assess susceptibility to impingement, dislocation, and edge loading wear. In this study, the accuracy and precision of a new radiographic cup orientation measurement system were assessed and compared to those of two commercially available systems. Two types of resurfacing hip prostheses and an uncemented prosthesis were assessed. Radiographic images of each prosthesis were created with the cup set at different, known angles of version and inclination in a measurement jig. The new system was the most accurate and precise and could repeatedly measure version and inclination to within a fraction of a degree. In addition it has a facility to distinguish cup retroversion from anteversion on anteroposterior radiographs

Grading the severity of soft tissue changes associated with metal-on-metal hip replacements:reliability of an MR grading system

Metal-on-metal (MoM) soft tissue reactions or aseptic lymphocytic vasculitis-associated lesions (ALVAL) are being recognised using metal artefact reduction (MAR) MR with increasing frequency following the advent of second generation metal-on-metal bearings, but there is no standardised technique for reporting of MR appearances in this disease. The aim of this study was to measure the reliability of a grading system designed for scoring the severity of MoM disease on MRI

MRI of aseptic lymphocytic vasculitis-associated lesions in metal-on-metal hip replacements

The aim of this review is to describe the clinical, histopathologic, and MRI features of aseptic lymphocytic vasculitis-associated lesions in total hip replacements

Sliding hip screws versus cancellous screws for femoral neck fractures:a systematic review and meta-analysis

Purpose: Both sliding hip screws (SHS) and cancellous screws are used in the surgical management of intracapsular femoral neck fracture. However, there is paucity of information as to which is the superior treatment modality. We performed this systematic review and meta-analysis study to compare the clinical outcomes of SHS and cancellous screws for the treatment of femoral neck fractures in adult patients. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL, up to December 2017. Randomized controlled trials (RCTs) directly comparing the clinical outcomes of SHS and cancellous screws for femoral neck fractures were retrieved with no language or publication year restrictions. Data retrieved included operative details, nonunion rate, avascular necrosis, reoperation, infection and mortality, hip pain, functional hip scores, and medical complications. These were pooled as risk ratio or mean difference (MD) with their corresponding 95% confidence interval (CI). Heterogeneity was assessed by Chi-square test. Results: Ten RCTs involving 1934 patients were included in the final analysis. The pooled estimate showed that the SHS group was associated with more intraoperative blood loss (MD = 110.01 ml, 95% CI [52.42, 167.60], p = 0.00002) than the cancellous screws. There was no significant difference in terms of operative time, postoperative hip function, nonunion, avascular necrosis, reoperation rate, infection, fracture healing, hip pain, medical complications, and mortality rate. Conclusion: Based on our study, the cancellous screws group was associated with less intraoperative blood loss in comparison with the SHS group. No other significant differences were found between the two interventions