January 02, 2015
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Findings support reliability of ultrasound screening to detect ALTR after THA

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When using MRI as a reference, ultrasound examinations provided reliable screening for the detection of clinically important adverse local tissue reaction legions surrounding metal-on-metal or highly cross-linked polyethylene bearings, according to study results.

Takashi Nishii, MD, and colleagues assessed 131 hips of 105 patients who received ultrasound and MRI examinations after total hip arthroplasty performed with either metal-on-metal (MoM) or highly cross-linked polyethylene (HXLPE) bearings and screened them for adverse local tissue reaction (ALTR).

Ultrasound examinations showed a similar frequency of periarticular abnormal patterns among patients who received MoM and HXLPE bearings, while MRI showed abnormal lesions of similar size and predominant involvement of Type I lesions in both groups. Between ultrasound and MRI findings, researchers found substantial agreement for the detection of abnormal lesions in both groups. When MRI findings were used as a reference, ultrasound examinations showed a sensitivity of 74%, specificity of 92% and accuracy of 84% in detection of abnormal lesions in the MoM group and sensitivity of 90%, specificity of 83% and accuracy in 85% in the HXLPE group. Results showed ultrasound examinations failed to detect ALTR in seven hips in the MoM group and two hips in the HXLPE group. However, ultrasound examinations detected ALTR in three hips in the MoM group and eight hips in the HXLPE group that were not shown with MRI, according to study results.

Disclosure: Nobuhiko Sugano is on the editorial board for the Journal of Arthroplasty and is a board member for Computer Assisted Orthopaedic Surgery International.