Metal artifact suppression at the hip: diagnostic performance at 3.0 T versus 1.5 Tesla

PurposeThis work aimed to compare the diagnostic performance of a metal artifact suppression sequence (MAVRIC-SL) for imaging of hip arthroplasties (HA) at 1.5 and 3 Tesla (T) field strength.MethodsEighteen patients (10 females; aged 27-74) with HA were examined at 3.0 and 1.5 T within 3 weeks. The sequence protocol included 3D-MAVRIC-SL PD (coronal), 3D-MAVRIC-SL STIR (axial), FSE T1, FSE PD and STIR sequences. Anatomical structures and pathological findings were assessed independently by two radiologists. Artifact extent and technical quality (image quality, fat saturation and geometric distortion) were also evaluated. Findings at 1.5 and 3.0 T were compared using a Wilcoxon signed rank test.ResultsWhile image quality was better at 1.5 T, visualization of anatomic structures and clinical abnormalities was not significantly different using the two field strengths (p > 0.05). Fat suppression and amount of artifacts were significantly better at 1.5 T (p  < 0.01). Inter- and intra-reader agreement for different anatomic details, image quality and visualization of abnormalities ranged from k = 0.62 to k = 1.00.ConclusionMAVRIC-SL at 1.5 T had a comparable diagnostic performance when compared MAVRIC-SL at 3.0 T; however, the higher field strength was associated with larger artifacts, limited image quality and worse fat saturation

The Future of Rheumatoid Arthritis and Hand Surgery - Combining Evolutionary Pharmacology and Surgical Technique

Rheumatoid arthritis is a systemic autoimmune disease of uncertain aetiology, which is characterized primarily by synovial inflammation with secondary skeletal destructions

Initial results with a mini-posterior approach for total hip arthroplasty

Implantation of the total hip prosthesis should always be as atraumatic as possible. The principle underlying this technique is to visualise the working area while keeping the aperture to a minimum, with a resulting reduction in trauma to the soft tissue. We present a new, improved single-incision approach in total hip arthroplasty: the mini-posterior approach. Preliminary results from 60 patients operated using this approach indicate rapid functional recovery, minimal postoperative pain, a reduced duration of hospitalisation, few complications, and optimal component positioning. Further follow-up is warranted

The Stolzalpe technique: a modified Watson-Jones approach

We report our experiences with minimally invasive total hip replacement performed via a modified Watson-Jones approach with a special positioning technique (the “Stolzalpe technique”). With the patient placed in the conventional supine position, the contralateral leg is held in a gynaecological footrest to allow hyperextension, adduction and external rotation of the leg during femoral preparation. The first 117 patients operated with this technique were compared with a conventionally operated group. The patients operated with the Stolzalpe technique had superior results for nearly all study criteria, including time of operation, time of postoperative intensive care, blood loss, complications and Harris Hip Score. The Stolzalpe technique appears to be the best possible compromise between patient comfort and the surgical demands of proper implant positioning, minimization of anaesthetic risk, and reducing the time required for draping and positioning