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Semin Musculoskelet Radiol 2006; 10(1): 098-106
DOI: 10.1055/s-2006-934220
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Magnetic Resonance Imaging of Joint Replacements

Ali M. Naraghi1 , Lawrence M. White2
  • 1Royal London Hospital, Department of Diagnostic Imaging, London, United Kingdom
  • 2Mount Sinai Hospital and University Health Network, Department of Diagnostic Imaging, Toronto, Ontario, Canada
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Publication History

Publication Date:
03 March 2006 (online)

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ABSTRACT

An increasing number of joint replacements are being performed annually. Complications of joint arthroplasty are diverse and may involve the hardware as well as osseous and soft tissue components. Although modalities such as conventional radiography and scintigraphy remain the mainstay of radiological investigation, in some cases these traditional methods of imaging may be negative or underestimate the extent of disease. Magnetic resonance imaging (MRI) has been considered of limited benefit following arthroplasty because of severe image degradation caused by metallic components. However, with modification of pulse sequences, artifact reduction and improved visualization of periprosthetic tissues are achievable, enabling a comprehensive assessment of articular and nonarticular pathologies. The common artifacts in the presence of orthopedic hardware, optimization of pulse sequences to minimize metal-related artifacts, and the clinical uses of MRI following joint replacement, particularly with regard to total hip arthroplasty, total knee arthroplasty, and shoulder arthroplasty, are reviewed.

KEYWORDS

Magnetic resonance imaging - artifacts - arthroplasty

REFERENCES

  • 1 American Academy of Orthopaedic Surgeons .Arthroplasty and Total Joint Replacement Procedures 1991-2000. Available at http://www.aaos.org/wordhtml/research/arthropl.htm Accessed October 12, 2004
    Google Scholar
  • 2 Teeny S M, York S C, Mesko J W, Rea R E. Long-term follow-up care recommendations after total hip and knee arthroplasty.  J Arthroplasty. 2003;  18 954-962
    CrossrefPubMedGoogle Scholar
  • 3 Eustace S, Shah B, Mason M. Imaging orthopedic hardware with an emphasis on hip prostheses.  Orthop Clin North Am. 1998;  29 67-84
    CrossrefPubMedGoogle Scholar
  • 4 Chandler H P, Reineck F T, Wixson R L. Imaging orthopedic hardware with an emphasis on hip prostheses. Total hip replacement in patients younger than thirty years old. A five-year follow-up study.  J Bone Joint Surg Am. 1981;  63 1426-1434
    PubMedGoogle Scholar
  • 5 Weissman B N. Current topics in the radiology of joint replacement surgery.  Radiol Clin North Am. 1990;  28 1111-1134
    PubMedGoogle Scholar
  • 6 Callaghan J J, O'Rourke M R, Saleh K J. Why knees fail: lessons learned.  J Arthroplasty. 2004;  19(4 Suppl 1) 31-34
    CrossrefPubMedGoogle Scholar
  • 7 Bozic K J, Rubash H E. The painful total hip replacement.  Clin Orthop Relat Res. 2004;  420 18-25
    PubMedGoogle Scholar
  • 8 Dennis D A. Evaluation of painful total knee arthroplasty.  J Arthroplasty. 2004;  19(4 Suppl 1) 35-40
    PubMedGoogle Scholar
  • 9 Guermazi A, Miaux Y, Zaim S, Peterfy C G, White D, Genant H K. Metallic artefacts in MR imaging: effects of main field orientation and strength.  Clin Radiol. 2003;  58 322-328
    CrossrefPubMedGoogle Scholar
  • 10 Suh J S, Jeong E K, Shin K H et al.. Minimizing artifacts caused by metallic implants at MR imaging: experimental and clinical studies.  AJR Am J Roentgenol. 1998;  171 1207-1213
    PubMedGoogle Scholar
  • 11 Eustace S, Jara H, Goldberg R et al.. A comparison of conventional spin-echo and turbo spin-echo imaging of soft tissues adjacent to orthopedic hardware.  AJR Am J Roentgenol. 1998;  170 455-458
    PubMedGoogle Scholar
  • 12 Ganapathi M, Joseph G, Savage R, Jones A R, Timms B, Lyons K. MRI susceptibility artefacts related to scaphoid screws: the effect of screw type, screw orientation and imaging parameters.  J Hand Surg [Br]. 2002;  27 165-170
    CrossrefPubMedGoogle Scholar
  • 13 Laakman R W, Kaufman B, Han J S et al.. MR imaging in patients with metallic implants.  Radiology. 1985;  157 711-714
    PubMedGoogle Scholar
  • 14 Petersilge C A, Lewin J S, Duerk J L, Yoo J U, Ghaneyem A J. Optimizing imaging parameters for MR evaluation of the spine with titanium pedicle screws.  AJR Am J Roentgenol. 1996;  166 1213-1218
    PubMedGoogle Scholar
  • 15 White L M, Kim J K, Mehta M et al.. Complications of total hip arthroplasty: MR imaging-initial experience.  Radiology. 2000;  215 254-262
    PubMedGoogle Scholar
  • 16 White L M, Buckwalter K A. Technical considerations: CT and MR imaging in the postoperative orthopedic patient.  Semin Musculoskelet Radiol. 2002;  6 5-17
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Czervionke L F, Daniels D L, Wehrli F W et al.. Magnetic susceptibility artifacts in gradient-recalled echo MR imaging.  AJNR Am J Neuroradiol. 1988;  9 1149-1155
    PubMedGoogle Scholar
  • 18 Tien R D, Buxton R B, Schwaighofer B W, Chu P K. Quantitation of structural distortion of the cervical neural foramina in gradient-echo MR imaging.  J Magn Reson Imaging. 1991;  1 683-687
    PubMedGoogle Scholar
  • 19 Tormanen J, Tervonen O, Koivula A, Junila J, Suramo I. Image technique optimization in MR imaging of a titanium alloy joint prosthesis.  J Magn Reson Imaging. 1996;  6 805-811
    PubMedGoogle Scholar
  • 20 Ludeke K M, Roschmann P, Tischler R. Susceptibility artefacts in NMR imaging.  Magn Reson Imaging. 1985;  3 329-343
    CrossrefPubMedGoogle Scholar
  • 21 Arbogast-Ravier S, Gangi A, Choquet P, Brunot B, Constantinesco A. An in vitro study at low field for MR guidance of a biopsy needle.  Magn Reson Imaging. 1995;  13 321-324
    PubMedGoogle Scholar
  • 22 Jensen J H, Chandra R. Strong field behavior of the NMR signal from magnetically heterogeneous tissues.  Magn Reson Med. 2000;  43 226-236
    CrossrefPubMedGoogle Scholar
  • 23 Sofka C M, Potter H G. MR imaging of joint arthroplasty.  Semin Musculoskelet Radiol. 2002;  6 79-85
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Olsen R V, Munk P L, Lee M J et al.. Metal artifact reduction sequence: early clinical applications.  Radiographics. 2000;  20 699-712
    CrossrefPubMedGoogle Scholar
  • 25 Frazzini V I, Kagetsu N J, Johnson C E, Destian S. Internally stabilized spine: optimal choice of frequency-encoding gradient direction during MR imaging minimizes susceptibility artifact from titanium vertebral body screws.  Radiology. 1997;  204 268-272
    PubMedGoogle Scholar
  • 26 Viano A M, Gronemeyer S A, Haliloglu M, Hoffer F A. Improved MR imaging for patients with metallic implants.  Magn Reson Imaging. 2000;  18 287-295
    CrossrefPubMedGoogle Scholar
  • 27 Tartaglino L M, Flanders A E, Vinitski S, Friedman D P. Metallic artifacts on MR images of the postoperative spine: reduction with fast spin-echo techniques.  Radiology. 1994;  190 565-569
    PubMedGoogle Scholar
  • 28 Bakker C J, Bhagwandien R, Moerland M A, Fuderer M. Susceptibility artifacts in 2DFT spin-echo and gradient-echo imaging: the cylinder model revisited.  Magn Reson Imaging. 1993;  11 539-548
    PubMedGoogle Scholar
  • 29 Czerny C, Krestan C, Imhof H, Trattnig S. Magnetic resonance imaging of the postoperative hip.  Top Magn Reson Imaging. 1999;  10 214-220
    PubMedGoogle Scholar
  • 30 Dixon W T. Simple proton spectroscopic imaging.  Radiology. 1984;  153 189-194
    CrossrefPubMedGoogle Scholar
  • 31 Moriguchi H, Lewin J S, Duerk J L. Dixon techniques in spiral trajectories with off-resonance correction: a new approach for fat signal suppression without spatial-spectral RF pulses.  Magn Reson Med. 2003;  50 915-924
    CrossrefPubMedGoogle Scholar
  • 32 Rybicki F J, Chung T, Reid J, Jaramillo D, Mulkern R V, Ma J. Fast three-point Dixon MR imaging using low-resolution images for phase correction: a comparison with chemical shift selective fat suppression for pediatric musculoskeletal imaging.  AJR Am J Roentgenol. 2001;  177 1019-1023
    PubMedGoogle Scholar
  • 33 Wohlgemuth W A, Roemer F W, Bohndorf K. Short tau inversion recovery and three-point Dixon water-fat separation sequences in acute traumatic bone fractures at open 0.35 tesla MRI.  Skeletal Radiol. 2002;  31 343-348
    CrossrefPubMedGoogle Scholar
  • 34 Ma J, Singh S K, Kumar A J, Leeds N E, Zhan J. T2-weighted spine imaging with a fast three-point Dixon technique: comparison with chemical shift selective fat suppression.  J Magn Reson Imaging. 2004;  20 1025-1029
    CrossrefPubMedGoogle Scholar
  • 35 Huegli R W, Tirman P F, Bonel H M et al.. Use of the modified three-point Dixon technique in obtaining T1-weighted contrast-enhanced fat-saturated images on an open magnet.  Eur Radiol. 2004;  14 1781-1786
    PubMedGoogle Scholar
  • 36 Ramos Cabrer P, van Duynhoven JPM, Van der Toorn A, Nicolay K. MRI of hip prostheses using single-point methods: in vitro studies towards the artifact-free imaging of individuals with metal implants.  Magn Reson Imaging. 2004;  22 1097-1103
    PubMedGoogle Scholar
  • 37 Tigges S, Stiles R G, Roberson J R. Complications of hip arthroplasty causing periprosthetic radiolucency on plain radiographs.  AJR Am J Roentgenol. 1994;  162 1387-1391
    PubMedGoogle Scholar
  • 38 Twair A, Ryan M, O'Connell M, Powell T, O'Byrne J, Eustace S. MRI of failed total hip replacement caused by abductor muscle avulsion.  AJR Am J Roentgenol. 2003;  181 1547-1550
    CrossrefPubMedGoogle Scholar
  • 39 Pfirrmann C, Zanetti M, Dora C, Hodler J. MR imaging of abductor tendons and muscles after total hip arthroplasty in asymptomatic and symptomatic patients. Presented at Annual Meeting of the Radiological Society of North America (SSK24-06);. December 1, 2004 Chicago, IL;
    Google Scholar
  • 40 Potter H G, Nestor B J, Sofka C M, Ho S T, Peters L E, Salvati E A. Magnetic resonance imaging after total hip arthroplasty: evaluation of periprosthetic soft tissue.  J Bone Joint Surg Am. 2004;  86 1947-1954
    PubMedGoogle Scholar
  • 41 Cook S M, Pellicci P M, Potter H G. Use of magnetic resonance imaging in the diagnosis of an occult fracture of the femoral component after total hip arthroplasty. A case report.  J Bone Joint Surg Am. 2004;  86 149-153
    PubMedGoogle Scholar
  • 42 Sugimoto H, Hirose I, Miyaoka E et al.. Low-field-strength MR imaging of failed hip arthroplasty: association of femoral periprosthetic signal intensity with radiographic, surgical, and pathologic findings.  Radiology. 2003;  229 718-723
    CrossrefPubMedGoogle Scholar
  • 43 Vince K G. Why knees fail.  J Arthroplasty. 2003;  18(3, Suppl 1) 39-44
    CrossrefPubMedGoogle Scholar
  • 44 Fehring T K, Odum S, Griffin W L, Mason J B, Nadaud M. Early failures in total knee arthroplasty.  Clin Orthop Relat Res. 2001;  392 315-318
    PubMedGoogle Scholar
  • 45 Sharkey P F, Hozack W J, Rothman R H, Shastri S, Jacoby S M. Insall Award paper. Why are total knee arthroplasties failing today?.  Clin Orthop Relat Res. 2002;  404 7-13
    CrossrefPubMedGoogle Scholar
  • 46 Sofka C M, Potter H G, Figgie M, Laskin R. Magnetic resonance imaging of total knee arthroplasty.  Clin Orthop Relat Res. 2003;  406 129-135
    CrossrefPubMedGoogle Scholar
  • 47 Sperling J W, Potter H G, Craig E V, Flatow E, Warren R F. Magnetic resonance imaging of painful shoulder arthroplasty.  J Shoulder Elbow Surg. 2002;  11 315-321
    CrossrefPubMedGoogle Scholar
  • 48 Goutallier D, Postel J M, Zilber S, Van Driessche S. Shoulder surgery: from cuff repair to joint replacement. An update.  Joint Bone Spine. 2003;  70 422-432
    CrossrefPubMedGoogle Scholar

Lawrence M WhiteM.D. 

Mount Sinai Hospital and University Health Network, Department of Diagnostic Imaging

600 University Avenue, Toronto, Ontario, Canada, M5G 1X5

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