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Thomas MS, Wimhurst JA, Nolan JF, et al. Imaging Metal-on-Metal Hip Replacements: the Norwich Experience. HSS J. 2013;9(3):247-56doi: 10.1007/s11420-013-9357-5.
Thomas, M. S., Wimhurst, J. A., Nolan, J. F., & Toms, A. P. (2013). Imaging Metal-on-Metal Hip Replacements: the Norwich Experience. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 9(3), 247-56. https://doi.org/10.1007/s11420-013-9357-5
Thomas, Marianna S, et al. "Imaging Metal-on-Metal Hip Replacements: the Norwich Experience." HSS journal : the musculoskeletal journal of Hospital for Special Surgery vol. 9,3 (2013): 247-56. doi: https://doi.org/10.1007/s11420-013-9357-5
Thomas MS, Wimhurst JA, Nolan JF, Toms AP. Imaging Metal-on-Metal Hip Replacements: the Norwich Experience. HSS J. 2013 Oct;9(3):247-56. doi: 10.1007/s11420-013-9357-5. Epub 2013 Aug 24. PMID: 24039614; PMCID: PMC3772162.
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HSS J. 2013 Oct;9(3):247-56. doi: 10.1007/s11420-013-9357-5. Epub 2013 Aug 24.

Imaging Metal-on-Metal Hip Replacements: the Norwich Experience.

HSS journal : the musculoskeletal journal of Hospital for Special Surgery

Marianna S Thomas, James A Wimhurst, John F Nolan, Andoni P Toms

Affiliations

  1. Departments of Radiology, Norfolk & Norwich University Hospitals NHS Trust, Norwich, UK.

PMID: 24039614 PMCID: PMC3772162 DOI: 10.1007/s11420-013-9357-5

Abstract

BACKGROUND: Adverse reaction to metal debris is a relatively recently described and often a silent complication of metal-on-metal (MOM) total hip replacements (THR). The Norfolk & Norwich University Hospital has been performing metal artefact reduction (MARS) MRI for 8 years in a variety of different types of MOM THR.

QUESTIONS/PURPOSES: The aims of this review are to describe the experience of using MARS MRI in Norwich and to compare our experience with that published by other groups.

METHODS: A MEDLINE keyword search was performed for studies including MRI in MOM THR. Relevant publications were reviewed and compared with published data from the Norfolk & Norwich University Hospital. The similarities and differences between these data were compared and possible explanations for these discussed.

RESULTS: MARS MRI appears to be the most useful tool for diagnosing, staging and monitoring adverse reactions to metal debris (ARMD). There appears to be no clinically useful association between clinical and serological markers of disease and the severity of MR findings. Although severe early ARMD is associated with significant morbidity, mild disease is often stable for years. If patients with normal initial MR examinations develop ARMD, this usually occurs 7 years. A 1-year interval between MRI examinations is reasonable in asymptomatic patients.

CONCLUSIONS: There is a general international consensus that ARMD is prevalent in symptomatic and asymptomatic patients with MOM THR and that while appearances vary with the type of prosthesis, there are characteristic features that make MARS MRI essential for diagnosis, staging and surveillance of the disease.

Keywords: ALVAL; MRI; arthroplasty; hip; metal-on-metal

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