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Polyethylene wear Radiology

Polyethylene wear (hip arthroplasty) Radiology Case

  1. Polyethylene wear is relatively common long-term complication of total hip arthroplasty. Gradual off-center migration of the prosthesis head is usually the first clue. It is important to also compare the position of the prosthesis to the initial postoperative radiographs during follow-up, as between two subsequent radiographs the change might.
  2. With the increased prevalence of cementless fixation, polyethylene wear debris is the most common cause for initiating osteolysis. Eccentric position of the femoral head component within the acetabular component leads to polyethylene wear (, 1-, 4 20 23 24). Small particle disease can take place with any joint arthroplasty
  3. Evidence of polyethylene wear, which appears as asymmetric positioning of the femoral head within the acetabular cup, often coexists with particle disease. . Infection presents as irregular lucency with periosteal reaction, but may be difficult to differentiate from loosening and particle disease.In typical cases the imaging findings of.
  4. Polyethylene wear in the patellar component is much more difficult to identify on radiographs. Axial radiographs are better than lateral radiographs for evaluating the patellar polyethylene. Moderate to severe wear appears as obvious joint space narrowing . When wear is asymmetric, varus or valgus deformity or patellar tilt may be present
  5. Polyethylene Wear-induced Synovitis.— Wear of acetabular polyethylene liners in metal-on-polyethylene and ceramic-on-polyethylene implants is a primary cause of arthroplasty implant failure with time and is perhaps the best understood and most predictable type of arthroplasty component wear ( 44 )
  6. Polyethylene wear-induced osteolysis is typically geographic and contains particulate debris of intermediate signal intensity that replaces the normal periprosthetic trabecular bone and high-signal-intensity fat of the marrow (Figs 2, 9). This sharp contrast Radiology 2012;265(1):204-214

Current polyethylene bearings are made of ultra-high-molecular-weight polyethylene. Polyethylene is a durable high-performance plastic resin. Its strength, wear properties, low coefficient of friction, and the ability to mold or machine it into desired shapes have contributed to its success Figure 10-10 Polyethylene wear. A, Standing flexed posteroanterior (PA) view of both knees and a similar view 3 years later show that the distance between the medial femoral condyle (vertical line in A and B) and the tibial baseplate has decreased, indicating wear of the polyethylene liner. Ideally, positioning should be identical to make this. Total knee arthroplasty (TKA), or total knee replacement (TKR), or tricompartmental knee replacement is an orthopedic procedure whereby the three articular surfaces of the knee (femoral, tibial, and patellar) are replaced by prosthetic components. TKA is the most common joint arthroplasty performed in the United States, with an estimated 672,000 TKAs performed in 2009 Wear of the polyethylene component in total hip replacement surgery now is recognized as the most common cause of prosthetic failure. 15,33,39 Although complete wear of the acetabular component has immediate and catastrophic consequences, 26,37 prosthetic failure mainly is attributable to particulate debris from the prosthesis in the form of stainless steel, 23 CoCr, 3 Ti, 1 bone cement, 21.

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Polyethylene wear is a major limitation to the long-term durability of TKA and remains a leading cause of revision . Polyethylene wear results in shedding of polyethylene debris, inciting a host inflammatory response and synovitis. However, little is known about the MRI appearance of synovitis in the setting of TKA polyethylene wear Introduction. In the mid-1980s, a new design for a shoulder prosthesis was envisioned by Professor Paul Grammont (, 1), and the prosthesis was released for use in Europe in the early 1990s.Professor Grammont published his initial experience with his newly redesigned Delta shoulder prosthesis in 1993 in an article coauthored by E. Baulot (, 2).This new prosthesis, also called the reverse. Wear of polyethylene has seen some interesting changes in orthopedic history. After attempting gamma-irradiation in air as a means for sterilization of the polyethylene, accelerated wear was observed. This method of sterilization leads to oxidation of the polyethylene, weakening the connection between molecules Wear . Polyethylene wear can result in joint asymmetry on an AP radiograph and is frequently associated with osteolysis. It is suggested by interval decrease in the space between the femoral condyles and the tibial baseplate on serial AP and lateral radiographs. One study that used ultrasound for the assessment of polyethylene wear reported the.

Complications of Total Hip Arthroplasty: Prevention and

Rarer complications such as polyethylene wear, periprosthetic fracture, and soft tissue pathology are also discussed. Although the mainstay of imaging is radiographs, newer techniques in TKA imaging such as computed tomography and magnetic resonance imaging are also reviewed Complications of total hip arthroplasty are common and it is essential for the radiologist to be aware of them in the assessment of radiographs of total hip replacements.. Complications are many and can occur at various time intervals following the initial surgery: aseptic loosening: considered to be the most common indication for revision surgery 1,2, us malalignment, respectively. For each group, gravimetric wear of the polyethylene inserts was measured for 5,000,000 cycles. Knee wear testing showed significantly different results for the three groups. Low intensity group inserts had mean wear rates of 3.1 (± 1.2) mg per million cycles. High intensity group inserts had significantly higher mean wear rates of 7.4 (± 2.7) mg per million. This liner results in decreased wear when compared to conventional polyethylene components and possibly a decrease in osteolysis. A 10-fold decrease in mean liner wear per year has been noted (0.20 for conventional polyethylene liners versus 0.02 mm/year). Particle size is also different compared to conventional polyethylene components Patterns of glenoid wear in osteoarthritis versus inflammatory arthritis. (a) Axial computed tomographic (CT) image of a 72-year-old woman shows glenohumeral joint osteoarthritis manifested by osteophyte formation in proportion to the degree of joint space narrowing, which typically leads to a pattern of asymmetric posterior glenoid wear (arrow)

ienced nonzero wear rates and visible wear damage. Five liner groups were examined: three with a range of irradiation doses without heat treatment, and two irradiated to 100 kGys, one with remelting, and the other annealing. All groups had been worn in a hip simulator under impingement conditions that produced nonzero wear rates and loss of machining marks. Each liner was cut into quadrants. Rarer complications such as polyethylene wear, periprosthetic fracture, and soft tissue pathology are also discussed. Although the mainstay of imaging is radiographs, newer techniques in TKA imaging such as computed tomography and magnetic resonance imaging are also reviewed. Seminars in Musculoskeletal Radiology, 23(2), E20-E35 Wear increased by 0.014 mm/year for each mm increment in overhang. The mean Oxford Knee Score was 39 for the cementless group and 38 for the cemented group at the 5-year follow-up. Interpretation - The wear-rates were similar for the 2 fixation methods, which supports further use of the cementless Oxford medial UKA Musculoskeletal Radiology. Musculoskeletal imaging concentrates on the skeleton, ligaments, muscles and joints, using CT, MRI, ultrasound and X-ray. Our Musculoskeletal Imaging Program is under the direction of Thomas J. Learch, MD, (center) who is fellowship-trained in musculoskeletal imaging. He leads a team of subspecialized physicians.

Sterilization by autoclaving or by irradiation in the presence of oxygen produces free radicals in the material, exposing the polyethylene to oxidation and making it more susceptible to wear. Actually, polyethylene sterilization is carried out by gamma radiation in an inert environment, typically in nitrogen gas or vacuum [ 15 ] Shoulder arthroplasty is the primary treatment of advanced glenohumeral arthritis once conservative measures fail, can restore function to patients limited by chronic rotator cuff deficiency, and serves as a treatment option for severe proximal humeral fractures [1, 2].Preoperative imaging of the bony and soft-tissue anatomy will be a primary determinant of the type of prosthesis that will be. The polyethylene tibial insert shape var-ies greatly as a result of the myriad TKA designs. Thus, one of the challenges during MRI interpretation is determining whether the appearance of the polyethylene tibial in-sert indicates an abnormality, such as poly-ethylene wear, or reflects the manufacturer's design. The main objective of this observa The polyethylene wear rates were calculated by measuring the shortest radius from the center of the prosthetic femoral head to a point on the outer surface of the acetabular cup. An immediate postoperative radiograph was compared with a follow-up radiograph at least 9.5 years later For MOM THA, mechanical edge wear at the femoral-acetabular articulation is a prominent source of metal debris.[34 35] Fretting and corrosion are additional modes of metallic degradation at the head-neck junction taper and neck-stem junction of modular hip arthroplasty prostheses.[17 23 26 27 28 31] Fretting is the process of mechanical wear by.

Polyethylene wear in total hip arthroplasty; comparing Oxinium and CoCr femoral heads using radiostereometry with 10 years follow-up. Håkon Greve Johannessen 1 , Thomas Kadar 2 , Geir Hallan 1,3,4 , Anne Marie Fenstad 3 , Kristin Haugan 5 , Paul Johan Høl 1,6 , Mona Badawy 4 , Terje Stokke 7 , Benedikt Jonsson 9 , Kari Indrekvam 1,4 , Arild. The Journal of Arthroplasty Vol. 14 No. 2 1999 Polyethylene Wear and Synovitis in Total Hip Arthroplasty A Sonographic Study of 48 Hips Uldis Kesteris, MD,* Kjell Jonsson, MD, PhD,~ Otto Robertsson, MD,* Roll Onnerf~ilt, MD, PhD,* and Hans Wingstrand, MD, PhD* Abstract: Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined.

Trunnionosis is emerging as an early mode of failure in conventional metal-on-polyethylene total hip arthroplasty. It is defined as wear or corrosion at the trunnion, the taper at the femoral head-neck interface. Trunnion wear can result in a variety of negative sequelae and, in severe cases, necessitate revision arthroplasty. We describe a 64-year-old man with a metal-on-polyethylene total. Among other things, weight bearing exposes the true alignment, ligamentous laxity and polyethylene wear. On the basis of follow-up of our TKA cases, we have drawn up a protocol for assessing postoperative X-ray films after TKAs. Following the proposed sequence, surgeon can easily decide how to proceed with follow-up and foresee complications.. Introduction. Osteolysis induced by polyethylene wear particles is one of the major causes of long-term failure in total joint arthroplasties [].The wear in a THA depends on the type of implant, the patient, and surgical factors that interact in complex ways [].Several studies have attempted to explain wear mechanisms using finite element [] or elasticity analysis [33, 34] Additional foci of endosteal scalloping may also be seen. Unlike infection, a periosteal reaction is not seen in cases of particle disease. Along the same lines, polyethylene wear is a common entity seen in both the hip and knee prosthesis (Figure 10-15). Figure 10-14. Aggressive granulomatosis (particle disease) in total hip arthroplasty (THA)

Joint Arthroplasties and Prostheses RadioGraphic

To describe the imaging findings of polyethylene liner dissociation in total hip arthroplasty. Retrospective search of our institution's radiology database identified 12 patients with polyethylene liner dissociation of a total hip arthroplasty. Clinical and operative notes were reviewed. All radiological studies were reviewed independently by two radiologists Polyethylene Wear and Osteolysis. There are four modes of wear 18. Mode I is an articulation between intended bearing surfaces (i.e., between the femoral condyle and tibial insert; mode II is articulation between the primary bearing surface (femoral condyle) and a surface that was never intended to be a bearing surface (metal backing of. Orthobullets. 1 hr ·. Irradiation of polyethylene in air (i.e. oxygen present) has been shown to be a risk factor for catastrophic failure after total knee replacement. Free radicals are generated when polyethylene is irradiated in the presence of air. Initially, these free radicals result in cross-linking An eccentric position of the prosthetic femoral head suggests polyethylene wear as the femoral head penetrates into the acetabular cup (usually superiorly; Fig. 15). 23 Although serial radiography is useful in detecting polyethylene wear, SPECT-CT is superior in detecting early changes, especially when there is suspicion of associated osteolysis

The Radiology Assistant : Hip - Arthroplasty

The Radiology Assistant : Arthroplast

Current Concepts in Knee Replacement: Complications

MR Imaging of Hip Arthroplasty Implants RadioGraphic

MR Imaging of Knee Arthroplasty Implants RadioGraphic

Total hip arthroplasty constitutes the operation of the century, although not without complications, which require revision surgery due to loosening, infection, dislocation, and wear. Hereby, we report a rare case of acetabular shell wear misdiagnosed as a dislocation. Patients who underwent total hip arthroplasty with ultra-high molecular weight polyethylene are more vulnerable to excessive. Musculoskeletal Radiology Radiology Case. 2010 Sep; 4(9):7-17 Early wear of the polyethylene liner leads to deposition of small particles of polyethylene into adjacent tissues with associated giant cell reaction and synovitis [6]. Further wear can lead to metal-on-metal contact, and thus shedding of metal debris..

Current Concepts in Knee Replacement: Features and Imaging

Other findings: Polyethylene wear was diagnosed if the head of the arthroplasty was eccentric in combination with osteolyticlesions in the femur or acetabulum. MRI evaluation MR images were reviewed and reported by a specialized musculoskeletal radiologist with 15 years of experience in musculoskeletal radiology, blinded to SPECT/CT results Little has been published on the outcomes of polyethylene liner exchanges for wear or osteolysis. We assessed 24 patients from our clinic who had an isolated polyethylene liner exchange for wear or osteolysis with retention of the acetabular shell and femoral stem. At a mean 56-month follow-up time, 6 hips (25%) had dislocated (OBQ09.126) A 60-year-old male had a total hip replacement 8 years ago. There is evidence of eccentric polyethylene wear and some retroacetbular osteolysis. You discuss treatment options of acetabular revision if the component is found to be loose intra-operatively versus isolated polyethylene exchange if the acetabular component is stable intra-operatively with the patient Polyethylene wear measurements were performed in one experienced laboratory using the method of Martell et al. There was no hip with pelvic or femoral osteolysis. The median linear wear rate was 0. Common etiologies of a painful or dysfunctional hip arthroplasty are mechanical loosening, polyethylene wear-induced osteolysis, adverse local tissue reaction to metal wear products, infection, fractures, heterotopic ossification, tendinopathy, and nerve injury

Imaging of Total Knee Arthroplasty Musculoskeletal Ke

Yamaguchi M, Hashimoto Y, Akisue T, Bauer TW: Polyethylene wear vector in vivo: A three dimensional analysis using retrieved acetabular components and radiographs. J Orthop Res. 17:695-702, 1999. Bauer TW, Schils J: The Pathology of Total Joint Arthroplasty: I. Mechanisms of implant fixation. Skeletal Radiology. 28:423-432, 1999. and II Yoshimi Endo, Christian Geannette, William T. Chang, Imaging evaluation of polyethylene liner dissociation in total hip arthroplasty, Skeletal Radiology, 10.1007/s00256-019-03232-x, (2019). Crossref Volume 33 , Issue 1

Particles of polyethylene wear are known to cause inflammation, pain, stiffness and loosening. A number of strategies can be used to avoid unwanted contract between the humeral polyethylene cup and the scapula. One is to use a glenoid component with lateral offset as shown on the right below Polyethylene wear in total hip prostheses: the influence of direction of linear wear on volumetric wear determined from radiographic data Authors (first, second and last of 7) R. Koša Friction between a polyethylene pin and a microtextured CoCrMo disc, and its correlation to polyethylene wear, as a function of sliding velocity and contact pressure, in the context of metal-on-polyethylene prosthetic hip implants. Tribol Int. 2018; 127:568-574. Crossref, Medline, Google Scholar; 4. Borjali A, Langhorn J, Monson K, et al Therefore, FDG-PET detected inflammatory reaction caused by polyethylene wear in total hip arthroplasty and allowed clinicians to decide on interventions, including removal of granulomatous tissue and the replacement of worn artificial joint components to prevent aseptic loosening. Radiology, (1):243-247 1996 MED: 865792 In cases of polyethylene wear, con- ethylene wear. Clin Orthop Relat Res. 2006; ment with consequent dislocation.8 In ventional radiology is able to highlight (447):66-69. the current case, ceramic liner breakage asymmetry in the relationship between 9

Total knee arthroplasty Radiology Reference Article

Polyethylene wear debris can however lead to osteolysis, bone loss, aseptic loosening and eventually failure of the implant, especially in high demand young patients . Metal-on-metal (MM) total hip arthroplasty is an alternative to overcome polyethylene wear induced prosthetic failure The relationship of radiographic pelvic osteolysis to computed tomographic (CT) volume and polyethylene wear remains controversial. We evaluated the sensitivity and specificity of radiographs in detecting osteolysis considering CT scan as the true value, in 118 hips with cementless cups Polyethylene wear-induced osteolysis is a common complication of total hip arthroplasty. We report a case of a patient who had an extensile osteolytic lesion that presented as a tumor-like thigh mass associated with a polyethylene wear debris-induced granuloma 18 years after cementless total hip arthroplasty. The patient received a proximally porous-coated stem that had not fully.

Assessment of Polyethylene Wear in Total Hip Replacement

Introduction. Polyethylene (PE) wear of more than 0.1-0.2 mm/year is associated with later osteolysis and failure of total hip arthroplasty (THA) (Sochart 1999, Dowd et al. 2000).In vitro simulator wear studies may not reflect the total sum of PE wear seen in vivo, and therefore continuous investigations of PE wear in the clinical setting with matching reports of the clinical outcome are. Wear of polyethylene (PE) components is widely regarded as the main factor limiting longevity of total hip arthroplasty (THA) (Cooper et al. 1992).Clinical studies have shown that periprosthetic osteolysis and aseptic loosening is strongly related to wear rates of above 0.2 mm/year (Sochart 1999, Dowd et al. 2000).Radiostereometric analysis (RSA) is the most accurate tool for in vivo.

methods of measuring wear. We conclude that CT imaging can be used as a clinical tool to detect early signs of polyethylene wear. Significance: Our in-vivo and ex-vivo liner wear data indicate that CT technology can be used to detect early wear in the polyethylene liner of THAs Skeletal Radiology, 2003. Polyethylene wear ume of the prosthesis cup due to wear, is linearly propor- particles have been held responsible for the development tional to the linear wear and to the square of the radius of of chronic periprosthetic inflammation, which over a pe- the head of the prosthesis [13, 14]. riod of several years leads. ethylene liner wear, according to both radiologists (κ=1.00). Unlike polyethylene liner wear, however, this eccentric posi- tioning was abrupt and new when compared to the prior ra wear and aseptic loosening. Wear of the polyethylene liner is often the limiting factor for the longevity of the implant. The liner material used most often has been polyethylene with varying degrees of crosslinking (Thomas et al. 2011). Several wear measurement techniques have been developed American College of Radiology loosening, glenohumeral instability, polyethylene wear, osteolysis, periprosthetic fracture, impingement (mainly with reverse total shoulder arthroplasties), tears of the rotator cuff tendons, infection, nerve injury, and deltoid dysfunction [2]. The most common complication for hemiarthroplasties has been.

Frondlike Synovitis on MRI and Correlation With

Radiologic Assessment of Reverse Shoulder Arthroplasty

prosthetic loosening. The highly cross-linking of polyethylene inserts in acetabular cups and knee liners has diminished wear and occurrence of small particle disease. The cross-linking process has improved wear resistance of polyethylene liners without impairment of other significant material properties (9) Wear of the polyethylene liner was a common complication in the first generation uncemented cups due to suboptimal sterilization technique, bad locking mechanisms of the liner in the metal shell, and thin polyethylene liners [9, 10]. Patients with these cups have a reported high risk for revision in the Swedish Hip Arthroplasty Register (SHAR) Polyethylene wear ( Fig. 23 Fig. 24) • Due to the Normal loading a slight thinning in the area of the weight bearing is depicted as the plastic moulds itself and consedered normal. This remoulding of the cup is called creep. • Abnormal loading leads to pressure more lateral, resulting in polyethylene wear on the supero-lateral side and polyethylene wear improved by adding tantalum beads to the liner The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Nebergall, Audrey K, Kevin Rader, Henrik Palm, Henrik Malchau, and Meridith E Greene. 2015. Precision of radiostereometri

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In vivo and ex vivo measurement of polyethylene wear in total hip arthroplasty. Acta Orthopaedica, 2014. Lars Weidenhielm. Download PDF. Download Full PDF Package. This paper. A short summary of this paper. 37 Full PDFs related to this paper. READ PAPER Wear in the polyethylene over time generates particulate debris in the joint, triggering an immune response that results in bone loss around the joint and failure of the implant (see Figure 1). The incidence of osteolysis with conventional polyethylene joint implants has been reported to be as high as 37% at 8 to 10 years after surgery The direct influence of this transition in contact area on the wear pattern can be observed in retrieved patellar components, which often demonstrate deformation and development of characteristic facets at the margin of the polyethylene patellar surface. 136, 198, 200 Such changes may be described as a wearing-in phenomenon, as it demonstrates.