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 retro...

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Bibliographic Details
Published in:The Journal of arthroplasty 2016, Vol.31 (1), p.260-263
Main Authors: Sutphen, Sean A., DO, MacLaughlin, Lewis H., MD, Madsen, Adam A., DO, Russell, Jackie H., RN, McShane, Michael A., MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - methods
Cobalt - blood
Cohort Studies
Female
Granuloma, Plasma Cell - diagnosis
Granuloma, Plasma Cell - epidemiology
hip arthroplasty
Hip Prosthesis
Humans
Ions - blood
Magnetic Resonance Imaging
Male
MARS-MRI
metal ion levels
metal-on-metal
Metals - chemistry
Middle Aged
Orthopedics
Prevalence
Prosthesis Design
pseudotumor
Retrospective Studies
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Summary: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.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2015.07.011