Magnetic Resonance Imaging as a Biomarker For Adverse Local Tissue Reaction In In

磁共振成像作为局部组织不良反应的生物标志物

• 批准号: 8715692
• 负责人: Matthew F. Koff
• 金额: $ 41.32万
• 依托单位: HOSPITAL FOR SPECIAL SURGERY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-15 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8715692
• 关键词: Activities of Daily Living; Adverse reactions; Advocate; Appearance; Arthroplasty; Biological Markers; Bone Resorption; Bone Tissue; Ceramics; Characteristics; Clinical; Data; Data Set; Decision Making; Degenerative polyarthritis; Devices; Diagnosis; Diagnostic; Diagnostic tests; Disease Progression; Failure; Gender; Head; Hip region structure; Histologic; Image; Implant; Individual; Infection; Intervention; Ions; Life; Magnetic Resonance Imaging; Metals; Methods; Monitor; Morbidity - disease rate; Morphologic artifacts; Operative Surgical Procedures; Orthopedics; Osteolysis; Pain; Patients; Pattern; Phase; Polyethylenes; Postoperative Period; Process; Reaction; Recruitment Activity; Risk; Risk Factors; Schedule; Serum; Signal Transduction; Surface; Surgeon; Survival Rate; Testing; Thick; Tissue Sample; Tissues; Total Hip Replacement; base; bone loss; capsule; cohort; hip replacement arthroplasty; longitudinal analysis; new technology; non-invasive imaging; premature; public health relevance; response; soft tissue; stem; tool

DESCRIPTION (provided by applicant): Total hip arthroplasty (THA) with metal-on-polyethylene (MOP) bearing materials have excellent survival rates but a common cause for implant failure is aseptic loosening caused by biologic reaction to wear debris. Alternative bearing surfaces, such as ceramics and metals, were developed as an alternative to MOP to reduce osteolysis due to polyethylene wear. The use of metal-on-metal (MOM) hip resurfacing arthroplasty (HRA) implants was initially advocated due to the perceived advantages over MOP; however, reactions to MOM wear debris in the expanded capsule have become a common cause of premature implant failure due to adverse local tissue reactions. Furthermore, monitoring local response to an implants requires high soft tissue contrast, as the adverse reactions are generated by the host synovial response. Magnetic resonance imaging (MRI) has superior soft tissue contrast but has traditionally been limited by the artifact generated by the components. In this study, we propose to develop MRI as a biomarker to detect adverse local tissue reactions for all bearing combinations and modular connections in THA. Individuals indicated for revision THA surgery will be recruited for pre-operative MRI studies, intra-operative tissue sampling for histologic analysis, and post- operative wear analysis of the retrieved implant. Correlations between the MRI datasets and the histologic and wear assessments will be performed and will be used to develop a predictive diagnostic tool for the management of THA patients. This predictive tool will be applied to cohort of individuals with primary THA to longitudinally monitor disease progression in patients with different individual risk factors and implant bearing surfaces.

描述（由申请人提供）：采用金属聚乙烯（MOP）承载材料的全髋关节置换术（THA）具有出色的存活率，但植入物失败的常见原因是磨损碎片的生物反应引起的无菌性松动。陶瓷和金属等替代轴承表面被开发作为 MOP 的替代品，以减少聚乙烯磨损引起的骨质溶解。最初提倡使用金属对金属 (MOM) 髋关节表面置换术 (HRA) 植入物，因为它比 MOP 具有明显的优势；然而，由于局部组织不良反应，扩张囊中对 MOM 磨损碎片的反应已成为种植体过早失效的常见原因。此外，监测植入物的局部反应需要高软组织对比度，因为不良反应是由宿主滑膜反应产生的。磁共振成像 (MRI) 具有出色的软组织对比度，但传统上受到组件产生的伪影的限制。在这项研究中，我们建议开发 MRI 作为生物标志物，以检测 THA 中所有轴承组合和模块化连接的不良局部组织反应。将招募需要进行翻修 THA 手术的个人进行术前 MRI 研究、术中检查 组织取样进行组织学分析，并对取回的种植体进行术后磨损分析。将进行 MRI 数据集与组织学和磨损评估之间的关联，并将用于开发用于管理 THA 患者的预测诊断工具。该预测工具将应用于初次全髋关节置换患者的队列，以纵向监测具有不同个体风险因素和种植体承载表面的患者的疾病进展。