Tuesday, February 1, 2011

Continuing Medical Education Panel sponsored by the American Orthopedics Association for Surgeons: Total hip Atheroplasty: Is there a MOM bearings controversy? (Part Three of Five)

Part Three of Five/my notes

Hollis Potter MD (Radiologist who has expertise in working with MARS MRI Protocols)

(Dr. Potter’s lecture  was covered in a prior post http://www.mydepuyhiprecall.com/201 0/12/using-mris-with-optimized-protocol-to.html//)
Rational for using MRI
·         We are looking at a process  that starts at the soft tissue level
·         3 dimensional problem so x-rays alone won’t suffice given they are 2 dimensional
·         CT exposes patients to higher level of radiation so they aren’t optimal
·        They ran a series of tests to detect osteolysis and found sensitivities to detection varied with the procedure used:
o   95% sensitivity with MRI (MRI had good sensitivity in all locations)
§  75% CT optimized
§  52% radiographs (plain films)
o    98% MRI specificity:
§  96% xray
§  100% CT
·         MRI is the most accurate means to detect bone loss in the presence of osteolysis
·         Pseudotumors occur with both MOM and MOP  Poly implants)
·         Not all soft tissue masses surrounding artheroplasties are wear-related.
·         Caution to implicate wear-induced diseases with no expansion of the pseudocapsule

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