title: Resection and Resolution of Bone Marrow Lesions Associated with an Improvement of Pain after Total Knee Replacement: A Novel Case Study Using a 3-Tesla Metal Artefact Reduction MRI Sequence.
abstract: We present our case report using a novel metal artefact reduction magnetic resonance imaging (MRI) sequence to observe resolution of subchondral bone marrow lesions (BMLs), which are strongly associated with pain, in a patient after total knee replacement surgery. Large BMLs were seen preoperatively on the 3-Tesla MRI scans in a patient with severe end stage OA awaiting total knee replacement surgery. Twelve months after surgery, using a novel metal artefact reduction MRI sequence, we were able to visualize the bone-prosthesis interface and found complete resection and resolution of these BMLs. This is the first reported study in the UK to use this metal artefact reduction MRI sequence at 3-Tesla showing that resection and resolution of BMLs in this patient were associated with an improvement of pain and function after total knee replacement surgery. In this case it was associated with a clinically significant improvement of pain and function after surgery. Failure to eradicate these lesions may be a cause of persistent postoperative pain that is seen in up to 20% of patients following TKR surgery.
authors.affiliation: Arthritis Research UK Pain Centre, Nottingham University, Nottingham, UK; Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, The University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Thomas
authors.identifier: 0000-0003-0370-3150
authors.initials: T
authors.lastname: Kurien
authors.affiliation: Arthritis Research UK Pain Centre, Nottingham University, Nottingham, UK; Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: Robert
authors.identifier: 0000-0002-3694-2345
authors.initials: R
authors.lastname: Kerslake
authors.affiliation: Arthritis Research UK Pain Centre, Nottingham University, Nottingham, UK; Academic Radiology, The University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Brett
authors.initials: B
authors.lastname: Haywood
authors.affiliation: Arthritis Research UK Pain Centre, Nottingham University, Nottingham, UK; Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, The University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Pearson
authors.affiliation: Arthritis Research UK Pain Centre, Nottingham University, Nottingham, UK; Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, The University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK; Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: Brigitte E
authors.initials: BE
authors.lastname: Scammell