The Ability of MRI to Detect Adverse Local Tissue Reaction and Implant Integration as a Function of Hip Implant Modularity

项目摘要 全髋关节置换术（THA）在减轻疼痛方面取得了成功，但最近的问题是， 提出了关于局部不良组织反应（ALTR）的发展。我们之前的申请集中在 利用MRI作为ALTR的非侵入性生物标志物，以便推荐适当的干预措施 在大面积损伤发生之前。通过对不同关节面材料全髋关节置换术的评价，我们发现：1）MRI可以检测到 并区分THA的磨屑; 2）MRI对不同关节面的ALTR损伤敏感 表面;和3）可变的主机介导的反应，磨损碎片安装不同的形态学模式的MRI。 作为传统的THA设计，对THA附近软组织的评价一直很有兴趣，包括 金属对聚乙烯（MOP）和陶瓷对聚乙烯（COP）关节面，最近已被 与ALTRs有关人们认为，头颈部连接处的微动磨损和腐蚀是导致 ALTR，继发于抗弯刚度和其他植入物机械特征。如果ALTR的患病率更高， 在具有更灵活连接的组件中发现，这可能会促使THA的实践更加严格 连接. 在这次更新申请中，我们将评估种植体失败的两个重要原因：（1）在设计中， 传统上与ALTR相关，如金属对聚乙烯（MOP）和陶瓷对聚乙烯（COP） 我们将通过MRI评估适用于THA翻修手术的患者，并将成像指标与 翻修时获得的靶向活检回收（包括耳轴），组织损伤程度 在手术时记录，并对股骨颈耳轴进行植入物取出分析，包括弯曲刚度分析; 和（2）使用骨-植入物的定性MRI评价纵向评估植入物整合 接口以及定量MRI技术，使用MAVRIC-UTE的T2标测和T2* 标测， 评估界面处的弛豫测量。

Project Summary Total hip arthroplasty (THA) has been successful in achieving pain reduction, but recent concerns have been raised regarding the development of adverse local tissue reactions (ALTRs). Our previous application focused on utilizing MRI as a noninvasive biomarker of ALTR, so that appropriate intervention can be recommended before extensive damage occurs. By evaluating THAs of different bearing materials we found: 1) MRI can detect and distinguish wear debris from THA; 2) MRI is sensitive to ALTR damage from different articulating surfaces; and 3) variable host-mediated response to wear debris mounts distinct morphologic patterns on MRI. There is continued interest in the evaluation of soft tissues near THAs as traditional THA designs, including metal-on-polyethylene (MOP) and ceramic-on-polyethylene (COP) bearing surfaces, have recently been implicated in ALTRs. It is believed that fretting and corrosion at the head-neck junction is responsible for ALTRs, secondary to flexural rigidity and other implant mechanical features. If a greater prevalence of ALTR is found in components with more flexible connections, this could drive the practice of THA to stiffer connections. In this renewal application, we will evaluate two important causes of implant failure: (1) in designs not traditionally associated with ALTRs such as metal-on-polyethylene (MOP) and ceramic-on-polyethylene (COP) we will assess patients indicated for revision THA surgery with MRI and correlate the imaging metrics to targeted biopsy retrieval obtained at the time of revision (including the trunnion), the extent of tissue damage documented at surgery, and implant retrieval analysis of the neck trunnion, including flexural rigidity analysis; and (2) to longitudinally assess implant integration using qualitative MRI evaluation of the bone-implant interface as well as quantitative MRI techniques, T2 mapping and T2* mapping using MAVRIC-UTE, to evaluate relaxometry at the interface.