E1585. Disjointed: Acute and Chronic Arthroplasty Complications
  1. Chad Downing; University of Washington
  2. David Camacho; University of Washington
  3. Christine Rehwald; University of Washington
Arthroplasty refers to the replacement, or resurfacing, of a joint, with the goal of restoring function and relieving pain. Joint replacement procedures are extremely common, with greater than one million knee and hip replacements alone performed in the United States each year. Frequent indications for arthroplasty include arthritis, trauma, osteonecrosis, and treatment of congenital abnormalities. The most commonly replaced joints include the knee, hip, and shoulder, although ankle, elbow, and various digit arthroplasties are also encountered with considerable frequency. Patients with joint replacements are imaged frequently, at routine postoperative intervals, for symptoms related to the replaced joint, and for unrelated issues in which the arthroplasty is incidentally visualized. Because of the high prevalence of joint replacements, complications are also common. Radiologists should be comfortable recognizing the appearance of acute and chronic pathologic processes affecting arthroplasties.

Educational Goals / Teaching Points
Discuss basic concepts, nomenclature, and the expected radiographic appearance of various arthroplasties. Review mechanisms of selected arthroplasty complications and their corresponding radiographic features, citing specific examples of each.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review the descriptive nomenclature and radiographic appearance of various different types of arthroplasty. Identify radiographic features of acute complications of joint replacement, including dislocation, periprosthetic fracture, infection, and component dissociation. Recognize radiographic findings related to chronic arthroplasty pathologies, such as particle disease, heterotopic ossification, aseptic loosening, and mechanical wear.

Joint replacement is an extremely common and highly successful treatment of advanced arthropathy. Due to the high prevalence of arthroplasty, particularly hip and knee, complications are also common, and may be initially asymptomatic. Imaging plays an important role in the recognition and management of arthroplasty complications. It is essential that radiologists are familiar with the usual appearance and complicating features of various joint replacements, as general and subspecialized radiologists are likely to encounter arthroplasties on a daily basis.