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，但最近的担忧是 提出了关于局部不良组织反应(ALTRs)的发展。我们之前的应用程序专注于 MRI作为急性呼吸窘迫综合征的无创性生物标志物的研究 在大范围的破坏发生之前。通过评估不同轴承材料的THA，我们发现：1)MRI可以检测到 2)mri对不同关节的altr损伤敏感。 3)不同的宿主对磨屑的反应在MRI上有不同的形态模式。 人们继续对临屋区附近的软组织进行评估，作为传统的临屋区设计，包括 金属-聚乙烯(MOP)和陶瓷-聚乙烯(COP)轴承表面最近被 与ALTRS有牵连。人们认为，头颈交界处的微动和腐蚀是导致 ALTRS，次要于弯曲刚性和其他种植体的机械特性。如果ALTR的患病率更高， 在具有更灵活连接的组件中发现，这可能会使THA的做法变得更加僵硬 关系。 在这次续订申请中，我们将评估种植体失败的两个重要原因：(1)在设计中 传统上与金属-聚乙烯(MOP)和陶瓷-聚乙烯(COP)等ALTR相关 我们将通过核磁共振对需要进行翻修全髋关节手术的患者进行评估，并将成像指标与 翻修时获得的靶向活检取材(包括耳轴)、组织损伤程度 记录在手术中，并对颈髓的种植取回进行分析，包括抗弯刚度分析； 以及(2)使用骨-种植体的定性MRI评价纵向地评价种植体的完整性 接口以及定量MRI技术、T2映射和使用MAVRIC-UTE的T2*映射，以 评估界面处的松弛测量法。

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.