(Fig 5-D.12) Aseptic Loosening vs. Fibrous Membrane Formation

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📌 Aseptic Loosening vs. Fibrous Membrane Formation

✅ Aseptic Loosening

• The term "loosening" should be reserved for cases where MR imaging demonstrates circumferential osseous resorption with such defined signs as implant displacement, rotation, and subsidence. 
• Bone resorption presents as a greater than 2 mm thick area of irregular interface between the prosthesis and bone.
• A layer of greater than 2 mm thickness with irregular margins may be qualified as bone resorption.

 

✅ Fibrous Membrane Formation

• The presence of fibrous membrane formation indicates limited implant fixation, which may or may not progress to component loosening but may warrant closer imaging surveillance. 
• Fibrous membrane formation is visualizable as a thin layer of high signal intensity on intermediate-weighted and STIR MR images of the interface between the host bone and the implant or cement. 
• As with radiography and computed tomography (CT), a 1–2 mm thick layer with smooth margins of the bone interface seen on MR images may be qualified as fibrous membrane formation.

 

References

1. RadioGraphics 2015; 35:1483–1501
2. Semin Musculoskelet Radiol 2019;23:e20–e35.

 

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#AsepticLoosening, #FibrousMembraneFormation, #BoneResorption, #MRIImaging, #Radiology, #Orthopedics, #Prosthesis, #ImplantFixation, #MedicalImaging, #BoneInterface