Adverse reaction to metal debris with concomitant incidental crystalline arthropathy in hip arthroplasty Edward J. Testa, BS, Brian J. McGrory, MD Arthroplasty.

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Adverse reaction to metal debris with concomitant incidental crystalline arthropathy in hip arthroplasty Edward J. Testa, BS, Brian J. McGrory, MD Arthroplasty Today Volume 3, Issue 1, Pages 19-23 (March 2017) DOI: 10.1016/j.artd.2016.10.005 Copyright © 2016 Terms and Conditions

Figure 1 (a) Patient 1, Anteroposterior (AP) radiograph at presentation shows no signs of osteolysis, loosening, or polyethylene wear of left THA. (b) Patient 1, lateral radiograph showing excellent fixation of left THA Arthroplasty Today 2017 3, 19-23DOI: (10.1016/j.artd.2016.10.005) Copyright © 2016 Terms and Conditions

Figure 2 Patient 1, metal artifact reduction sequence (MARS) MRI at presentation is unremarkable, showing no signs of pseudotumor or synovitis. Arthroplasty Today 2017 3, 19-23DOI: (10.1016/j.artd.2016.10.005) Copyright © 2016 Terms and Conditions

Figure 3 (a) Patient 2, AP radiograph at presentation demonstrates fibrous union of trochanteric slide osteotomy and associated screw breakage of left RA. (b) Patient 2, lateral demonstrates satisfactory fixation of left RA, with screw breakage. Arthroplasty Today 2017 3, 19-23DOI: (10.1016/j.artd.2016.10.005) Copyright © 2016 Terms and Conditions

Figure 4 Patient 2, MARS MRI at presentation showing evidence of nonunion and hardware migration associated with prior left trochanteric osteotomy. Arthroplasty Today 2017 3, 19-23DOI: (10.1016/j.artd.2016.10.005) Copyright © 2016 Terms and Conditions

Figure 5 (a) Patient 2, AP radiograph status after revision showing left THA after revision, including open reduction internal fixation of trochanteric nonunion with an autologous bone graft, and removal of fractured screw. (b) Patient 2, lateral radiograph showing left THA after revision. Arthroplasty Today 2017 3, 19-23DOI: (10.1016/j.artd.2016.10.005) Copyright © 2016 Terms and Conditions