title: MRI Findings Associated with Recalled Modular Femoral Neck Rejuvenate and ABG Implants.
abstract: MARS-MRI is suggested for the diagnosis of adverse local tissue reactions (ALTR) in patients with recalled femoral stems with modular necks, but there has been no major study looking at MARS-MRI findings in this population. A retrospective review was performed on 312 patients who received a modular neck hip implant between October 2007 and February 2012. 62% of patients had intra-articular effusions, with 27% containing debris. Extra-capsular effusions were present in 35% of hips. 54% had synovitis and 5.4% had osteolysis. Tendinopathy and tendon disruption was present in the gluteus medius (58%/12%), hamstring (56%/12%), gluteus minimus (38%/7.7%) and iliopsoas (7.1%/4.8%). Abnormal MARS-MRI findings are associated with modular neck femoral components and can suggest underlying ALTR. MARS-MRI abnormalities merit serious consideration in this population.
authors.affiliation: Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Walsh
authors.affiliation: Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: James C
authors.initials: JC
authors.lastname: Hubbard
authors.affiliation: St. Cloud Orthopaedics, St. Cloud, Minnesota.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Nessler
authors.affiliation: Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan; Providence Hospital and Medical Centers and The CORE Institute, Southfield, Michigan.
authors.forename: David C
authors.initials: DC
authors.lastname: Markel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D005269:Femur; D005272:Femur Neck; D006621:Hip Joint / Q000473:pathology* / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D057052:Medical Device Recalls; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D052256:Tendinopathy / Q000209:etiology / Q000473:pathology*; D055815:Young Adult
keywords: adverse local tissue reactions; chromium; cobalt; metal artifact reduction sequence magnetic resonance imaging; modular neck hip implants; revision total hip arthroplasty