MRI as a problem-solving tool in unexplained failed total hip replacement following conventional assessment

• Published in: Skeletal radiology 2007-10, Vol.36 (10), p.955-961
• Main Authors: JOHNSTON, Ciaran, KERR, Jennifer, FORD, Stephanie, O'BYRNE, John, EUSTACE, Stephen
• Format: Article
• Language: English
• Subjects: Adult; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - instrumentation; Biological and medical sciences; Equipment Failure Analysis - methods; Female; Hip Joint - pathology; Hip Joint - surgery; Hip Prosthesis - adverse effects; Humans; Joint Instability - diagnosis; Joint Instability - etiology; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Orthopedic surgery; Prosthesis Failure; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-007-0349-8

To evaluate MRI as a problem-solving tool for patients with an unexplained failed total hip replacement following conventional radiological assessment. Patients' informed consent was obtained in all cases. Institutional review board approval was obtained. Twenty-eight patients with unexplained failed total hip replacements following conventional radiological assessment underwent additional MR imaging with an optimised turbo-spin echo sequence. Images were reviewed by two musculoskeletal radiologists by consensus and compared with findings at surgery, or following response to image-guided intervention or clinical follow-up. Of the 28 patients, MRI revealed an unsuspected diagnosis explaining the cause of prosthesis failure in 15 patients. In eight of 15 patients in this group, subsequent minimally invasive image-guided intervention obviated the need for revision total hip replacement. No cause for prosthesis failure was identified in 13 patients. MRI may be successfully undertaken in patients following total hip replacement, and, when performed, it frequently leads to an unsuspected diagnosis, allowing informed patient treatment. In this study it allowed the identification of an unsuspected diagnosis in over 50% of cases.