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

描述（由申请人提供）：使用金属对聚乙烯（MOP）轴承材料的全髋关节置换术（THA）具有优异的存活率，但植入物失败的常见原因是由磨损碎片的生物反应引起的无菌性松动。替代承载表面，如陶瓷和金属，被开发作为MOP的替代品，以减少由于聚乙烯磨损造成的骨溶解。最初提倡使用金属对金属（MOM）髋关节置换术（HRA）植入物，因为它比MOP有明显的优势；然而，由于不良的局部组织反应，膨胀囊内MOM磨损碎片的反应已成为种植体过早失败的常见原因。此外，监测局部对植入物的反应需要高度的软组织对比，因为不良反应是由宿主滑膜反应产生的。磁共振成像（MRI）具有优越的软组织对比度，但传统上受到组件产生的伪影的限制。在这项研究中，我们建议发展MRI作为一种生物标志物来检测THA中所有轴承组合和模块连接的不良局部组织反应。需要翻修THA手术的患者将被纳入术前、术中MRI检查

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.