title: Prevalence of Pseudotumor in Patients After Metal-On-Metal Hip Arthroplasty Evaluated with Metal Ion Analysis and MARS-MRI.
abstract: The purpose of this study is to quantify the prevalence of pseudotumors in patients with well-functioning and painful metal-on-metal total hip arthroplasty, to characterize the pseudotumor with the use of MARS-MRI, and to assess the relationship between pseudotumors and metal ions. We retrospectively reviewed 102 single surgeon patients. The results showed that 68.6% developed pseudotumor with 60.9% of the asymptomatic group developing pseudotumor. The symptomatic group had a higher proportion of patients with elevated serum cobalt levels (P=0.035). There was no difference found with elevated metal ions and prevalence of pseudotumor, but elevated cobalt levels were associated with larger pseudotumor size (P=0.001). The available evidence indicated that most patients that develop pseudotumors are asymptomatic, and that elevated serum cobalt levels may be associated with symptoms and pseudotumor size.
authors.affiliation: Doctors Hospital, Columbus, Ohio.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Sutphen
authors.affiliation: Riverside Radiology and Interventional Associates, Inc., Columbus, Ohio.
authors.forename: Lewis H
authors.initials: LH
authors.lastname: MacLaughlin
authors.affiliation: Doctors Hospital, Columbus, Ohio.
authors.forename: Adam A
authors.initials: AA
authors.lastname: Madsen
authors.affiliation: Orthopedic One, Columbus, Ohio.
authors.forename: Jackie H
authors.initials: JH
authors.lastname: Russell
authors.affiliation: Orthopedic One, Columbus, Ohio.
authors.forename: Michael A
authors.initials: MA
authors.lastname: McShane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D003035:Cobalt / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000453:epidemiology; D006622:Hip Prosthesis; D006801:Humans; D007477:Ions / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008670:Metals / Q000737:chemistry*; D008875:Middle Aged; D015995:Prevalence; D011474:Prosthesis Design; D012189:Retrospective Studies
chemical_list: D007477:Ions; D008670:Metals; D003035:Cobalt
keywords: MARS-MRI; hip arthroplasty; metal ion levels; metal-on-metal; pseudotumor