Metal artifact reduction MRI of total ankle arthroplasty implants.

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Abstract

[Indexed for MEDLINE] 17. J Am Acad Orthop Surg. 2008;16 Suppl 1:S20-5. doi: 10.5435/00124635-200800001-00006. What are the guidelines for the surgical and nonsurgical treatment of periprosthetic osteolysis? Stulberg BN(1), Della Valle AG; Implant Wear Symposium 2007 Clinical Work Group. Collaborators: Callaghan JJ, Cuckler JM, Galante JO, Della Valle AG, Goodman SB, Huddleston JI, Jones LC, Lewallen DG, Malchau H, Maloney W, Marshall A, Paprosky W, Potter HG, Ries MD, Rosenberg A, Sculco TP, Stulberg BN, Tsao AK, Wright T. Author information: (1)Center for Joint Reconstruction, Cleveland Orthopaedic and Spine Hospital at Lutheran, Cleveland Clinic Health System, Cleveland, OH, USA. Periprosthetic osteolysis is most often diagnosed by plain radiographs. Because these radiographs routinely underestimate the extent of the lesion, three-dimensional imaging should be used early in the evaluation process to confirm the presenting extent of disease. If the osteolytic process is asymptomatic, scheduled regular follow-up should be instituted until the lesion can be confirmed to be stable or until the decision is made to proceed with surgery. Nonsurgical management with pharmacologic agents has not proved to be effective. If surgery is contemplated, a three-dimensional evaluation with magnetic resonance imaging or helical computed tomography can assist in preoperative planning. Surgical intervention requires complete débridement of the lesional membrane and removal of the wear-generator--with or without component removal and with or without bone grafting, depending on the individual circumstances. A standardized follow-up evaluation mechanism for all patients should be a part of total joint arthroplasty management. DOI: 10.5435/00124635-200800001-00006