However, Hart et al [43] followed postoperative patients with THAs undergoing routine follow-up, excluding patients with complications of fracture, dislocation, or infection or who had died. Of the 423 patients studied, 414 had radiographs at 6 to 12 weeks and 276 had follow-up radiographs at 1 year. No THA case was identified in which clinical management was changed by the radiographic examination in this time period. This suggested to the authors that, in asymptomatic patients, some follow-up radiographs might be omitted. Radiographs for follow-up of asymptomatic MoM total hip prostheses: The FDA recommends routine long-term follow-up of patients with MoM hip implants, typically to occur every 1 to 2 years [44]. This includes appropriate radiographs. Serial radiographs are helpful to assess subtle changes [42]. Radiographs can be used to assess component position, component loosening, bone quality, osteolysis, fracture, dislocation or subluxation, femoral neck narrowing, and medial femoral calcar erosion [36,45]. The latter may be an indicator of ARMD, warranting cross-sectional imaging (positive predicative value [PPV] 0.83) [45]. US Hip US for follow-up of asymptomatic non-MoM total hip prostheses: A few studies have investigated US to assess asymptomatic patients with metal-on-polyethylene (MoP) bearings [41,46]. Nishii et al [41] concluded that US seemed a promising noninvasive tool for detection of ARMD pseudotumors. However, there are no recent studies indicating the use of US for routine surveillance of nonmetal on metal prostheses. US for follow-up of asymptomatic MoM total hip prostheses: US may be beneficial as asymptomatic patients may show imaging changes of or associated with ARMD [46]. US can be used to detect pseudotumors (solid or cystic) and other findings seen with ARMD such as joint effusions, bursal collections, and synovitis [36,47-49].
Imaging after Total Hip Arthroplasty PCAs. However, Hart et al [43] followed postoperative patients with THAs undergoing routine follow-up, excluding patients with complications of fracture, dislocation, or infection or who had died. Of the 423 patients studied, 414 had radiographs at 6 to 12 weeks and 276 had follow-up radiographs at 1 year. No THA case was identified in which clinical management was changed by the radiographic examination in this time period. This suggested to the authors that, in asymptomatic patients, some follow-up radiographs might be omitted. Radiographs for follow-up of asymptomatic MoM total hip prostheses: The FDA recommends routine long-term follow-up of patients with MoM hip implants, typically to occur every 1 to 2 years [44]. This includes appropriate radiographs. Serial radiographs are helpful to assess subtle changes [42]. Radiographs can be used to assess component position, component loosening, bone quality, osteolysis, fracture, dislocation or subluxation, femoral neck narrowing, and medial femoral calcar erosion [36,45]. The latter may be an indicator of ARMD, warranting cross-sectional imaging (positive predicative value [PPV] 0.83) [45]. US Hip US for follow-up of asymptomatic non-MoM total hip prostheses: A few studies have investigated US to assess asymptomatic patients with metal-on-polyethylene (MoP) bearings [41,46]. Nishii et al [41] concluded that US seemed a promising noninvasive tool for detection of ARMD pseudotumors. However, there are no recent studies indicating the use of US for routine surveillance of nonmetal on metal prostheses. US for follow-up of asymptomatic MoM total hip prostheses: US may be beneficial as asymptomatic patients may show imaging changes of or associated with ARMD [46]. US can be used to detect pseudotumors (solid or cystic) and other findings seen with ARMD such as joint effusions, bursal collections, and synovitis [36,47-49].