Abstract
ObjectiveTo prospectively assess the evolution of postoperative MRI findings in asymptomatic patients after total hip arthroplasty (THA) over 24 months (mo).MethodsThis prospective cohort study included 9 asymptomatic patients (56.7 ± 15.0 years) after THA. Metal artifact–reduced 1.5-T MRI was performed at 3, 6, 12, and 24 mo after surgery. The femoral stem and acetabular cup were assessed by two readers for bone marrow edema (BME), periprosthetic bone resorption, and periosteal edema in addition to periarticular soft tissue edema and joint effusion.ResultsBME was common around the femoral stem in all Gruen zones after 3 mo (range: 50–100%) and 6 mo (range: 33–100%) and in the acetabulum in DeLee and Charnley zone II after 3 mo (100%) and 6 mo (33%). BME decreased substantially after 12 mo (range: 0–78%) and 24 mo (range: 0–50%), may however persist in particular in Gruen zones 1 + 7. Periosteal edema along the stem was common 3 mo postoperatively (range: 63–75%) and rare after 24 mo: 13% only in Gruen zones 2 and 5. Twelve months and 24 mo postoperatively, periprosthetic bone resorption was occasionally present around the femoral stem (range: 11–33% and 13–38%, respectively). Soft tissue edema occurred exclusively along the surgical access route after 3 mo (100%) and 6 mo (89%) and never at 12 mo or 24 mo (0%).ConclusionAround the femoral stem, BME (33–100%) and periosteal edema (0–75%) are common until 6 mo after THA, decreasing substantially in the following period, may however persist up to 24 mo (BME: 0–50%; periosteal edema: 0–13%) in few non-adjoining Gruen zones. Soft tissue edema along the surgical access route should have disappeared 12 mo after surgery.
Highlights
The number of patients undergoing hip replacement surgery has drastically increased over the last decades [1]
BME, bone marrow edema; THA, total hip arthroplasty joint fluid in the anterior (25% ≥ 3 mm for reader 1; 37.5% ≥ 3 mm for reader 2), medial (50% ≥ 3 mm for both readers), and lateral location (62.5% ≥ 3 mm for both readers), whereas no to mild joint effusion was present posteriorly during the whole follow-up period (100% < 3 mm for reader 1; 88–100% < 3 mm for reader 2) (Fig. 9)
No extraarticular fluid collection was present at any time. The purpose of this prospective longitudinal study was to show the natural evolution of normal periprosthetic MRI findings in the first 2 years after THA in asymptomatic individuals
Summary
The number of patients undergoing hip replacement surgery has drastically increased over the last decades [1]. Developed metal artifact reduction techniques such as Slice Encoding for Metal Artifact Correction (SEMAC) improve the detection of complications after THA [14,15,16,17,18] and advanced reconstruction techniques such as Compressed Sensing for SEMAC (CS-SEMAC) allow reducing the formerly long acquisition times [7, 19, 20]. These developments have sparked a new era in the visualization of the peri-implant region [1, 21]
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