(Fig 5-D.14) Aseptic Loosening vs. Osteolysis

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📌 Aseptic Loosening vs. Osteolysis

✅ 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.

 

✅  Polyethylene Wear-Induced Synovitis

• Frond-like synovial proliferation 
• Dense synovial proliferation
• Debris with low-to-intermediate signal intensity
• Variable amounts of joint fluid and distention

 

✅  Polyethylene Wear-Induced Osteolysis

• Geographic pattern
• Particulate debris with intermediate signal intensity
• Replacement of normal periprosthetic trabecular bone and marrow fat

References

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

 

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