Role of preoperative magnetic resonance imaging in patients with quiescent septic arthritis undergoing primary total hip arthroplasty |
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| Affiliation: | 1. Senior Arthroplasty Fellow, Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP, UK;2. Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP, UK;3. Consultant Musculoskeletal Radiologist, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP, UK;4. Consultant Arthroplasty Surgeon, Centre for Hip Surgery, Wrightington Hospital, Appley Bridge, Wigan WN6 9EP, UK;1. Department of Orthopaedic Surgery, Rutgers University, New Jersey Medical School, 140 Bergen Street, D-1610, Newark, NJ, 07103, USA;2. Department of Surgery, Rutgers University, New Jersey Medical School, 140 Bergen Street, D-1610, Newark, NJ, 07103, USA;3. Rutgers New Jersey Medical School, USA;1. Department of Orthopaedics, Pt.B.D.S. PGIMS, Rohtak, Haryana, India;2. Department of Anaesthesia, Pt.B.D.S. PGIMS, Rohtak, Haryana, India;1. Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, 110029, India;2. Nepal Cancer Hospital and Research Center, Lalitpur, Nepal;1. Orthopaedic Resident, Wellspan Orthopaedics, 25 Monument Rd., Suite 290, York, PA, 17403, USA;2. Wellspan Orthopaedics, 25 Monument Rd., Suite 290, York, PA, 17403, USA;3. Orthopaedic Oncologist, MedStar Georgetown Cancer Insitute, MedStar Franklin Square Medical Center, 9103 Franklin Square Drive, Suite 2300 Baltimore, MD, 21237, USA;1. Stanford Medicine, Department of Orthopaedic Surgery, Stanford, CA, 94305, USA;2. Stanford Medical School, Stanford, CA, 94305, USA |
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| Abstract: | Aimto evaluate the role of preoperative magnetic resonance imaging (MRI) in assessing patients with a history of quiescent hip septic arthritis undergoing total hip arthroplasty.Materials and methodsretrospective consecutive study of patients with previous history of septic arthritis who underwent MRI scans of their hips prior to primary hip arthroplasty surgery and who also had minimum 2 years follow up postoperatively. Detailed radiographic examinations were obtained, demographic and microbiological data collected. The primary outcome measure was whether a preoperative MRI scan had influenced the surgical decision-making and planning. Rate of recurrence of infection and complications was also collected at final follow up.Resultssixteen patients with quiescent hip septic arthritis were included. There were 4 males and 12 females with average age at time of primary hip arthroplasty 51.7 years (range 22–75). Five patients had childhood septic arthritis with no documented microbiology data. Eleven patients had adult onset septic arthritis. In patients with childhood septic arthritis the MRI findings were similar to those with degenerative joint disease and had no added value to the routine surgical work up. MRIs of patients with adult onset septic arthritis showed persistent findings of effusion, marrow oedema and soft tissue oedema and had no added value to the surgical planning. All but one underwent single stage total hip arthroplasty. At final follow up, with average 4.6 years (range 2–8), none had a recurrence of infection.ConclusionIn our experience, preoperative MRI scans did not influence the surgical decision making and are not recommended for routine practice in the surgical work up of quiescent septic arthritis prior to total hip arthroplasty. |
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| Keywords: | Hip septic arthritis Magnetic resonance imaging Total hip arthroplasty Diagnostic study |
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