Are endoprostheses a contraindication for MRI? Mri-examination of the hip joint Who did the MRI after hip arthroplasty.

It is carried out when conservative treatment pathology does not give results and the articular joint is destroyed. Recovery after the installation of the prosthesis takes from 2 months to six months. Transplantation solves the problem of a diseased joint, but does not eliminate other diseases internal organs. If there is a need for tomography, you will have to find out the composition of the metal of the endoprosthesis and come to terms with the fact that tomography in the transplant area will not give a clear picture of the disease.

Is it possible to do MRI with endoprostheses?

Magnetic resonance imaging is a study of a specific area or the entire body, when a series of specific images is obtained under the influence of nuclear resonance. The information obtained gives an accurate picture of the patient's health status. Since a strong magnetic field is involved during the study, there is doubt about the admissibility of the use of MRI for patients with endoprostheses.

The shape and material of modern prostheses does not allow them to heat up excessively. Therefore, endoprosthetics hip joint is not a contraindication for MRI.

What is the difficulty?

For people who have undergone arthroplasty, it is impossible to do an MRI in the operation area: the metal will glow and the doctor will not differentiate the pathology in the images. Before the procedure, it is necessary to inform the specialist about the installed prosthesis, bring the product passport, so that the doctor is convinced of the possibility of conducting the study. This is especially true for patients who underwent surgery more than 10 years ago.

Before the study, the doctor must look at the product passport in order to assess the likelihood of an error in the result.

Requirements for endoprostheses:

1. The main component of the alloy from which the prosthesis was made must be paramagnetic.
2. The alloy has a corresponding inertness.
3. The material meets the requirements of the Ministry of Health and has the necessary certifications.

Features of the

There are no special contraindications to the study with an artificial joint. However, before carrying out the procedure, it is necessary to make sure that the alloy from which the prosthesis is made is paramagnetic, because ferromagnetic metals under the influence of magnetic fields can:

• warm up;
• move.

Iron, nickel and cobalt are ferromagnetic, while titanium is paramagnetic. If the endoprosthesis is made of materials of different nature, such a joint will not move, but there is a possibility of warming up. In this case, the patient is given a special button. If he feels warm at the transplant site, it is necessary to give a signal to the specialist and the study is immediately stopped. MRI is a highly accurate method of studying the state of health, so you should not refuse it. The main thing is to observe all security measures.

AT daily practice we often face the same questions regarding certain aspects of the future life of a patient with an artificial joint. After a joint discussion, we have compiled a list of the most frequently asked questions by patients. We did not make it too lengthy so that it does not lose its practical significance. So:

What sports and physical activities will I have to give up after arthroplasty?

Any exercise should be avoided. axial load on the operated joint. Such sports include basketball and tennis and other sports where jumping and running are present.

What sports and physical exercise acceptable after endoprosthetics?

Patients are allowed and moreover encouraged after total arthroplasty aerobic activities such as walking up to 3 km per day, swimming, exercise bike and moderate strength training. If you are involved in any sport and would like to continue after the operation, you should discuss this with us prior to the operation.

When can I start swimming after arthroplasty?

After knee arthroplasty in 8-12 weeks

After hip arthroplasty in - 8-12 weeks

Important! the pool must be equipped with steps since you cannot use a vertical ladder to get up and down.

When can I drive?

As a rule, you will be able to drive 6 weeks after the operation. This issue is resolved after your first follow-up visit to us after the operation.

How long do I have to take precautions after total hip arthroplasty?

You must overdo the hip flexion limit to 90 degrees. Your doctor will show you how to pick up objects from the floor, put on socks. You must not cross your legs in postoperative period. Should not be worn more than 12 kg after surgery. You should not turn around through the operated joint.

I have noticed that the incision site at the knee or hip joint is warmer than the opposite. Should I be worried about this?

If you feel warm in the area of ​​the operation, but there is no redness, no discharge from the wound, and you do not have a fever, then you should not worry. Such heat in the wound area can persist for 4 months, and this is due to increased blood flow in the area of ​​the operation, which indicates wound healing.

Can I kneel?

Yes, you can stand on your operated knee 6 weeks after the operation, as long as you do not experience any discomfort while doing so.

What does it mean if I feel or hear a clicking sound in my knee after hip replacement?

The clicking is often felt after total knee replacement and usually appears as your activity increases. The reason may be the presence of liquid between the polyethylene liner and the metal femoral component at the moment of movement. If the click is not accompanied by pain, then this should not cause you concern.

How soon after the operation can I visit the dentist?

If you have an acute toothache you can visit the dentist immediately. But we must remember that after the operation, throughout your life, before any manipulations with the teeth at the dentist, you must take antibiotics. It is better to plan a planned visit to the dentist 12 weeks after the operation.

Who prescribes antibiotics before a visit to the dentist?

What infections should I be afraid of after arthroplasty?

The usual runny nose does not pose a threat, but if the runny nose is complicated by bronchitis or sinusitis, it is necessary to visit a therapist to prescribe antibiotics.

• Infections requiring attention:
• dental abscess
• Urinary tract infections
• Wound infections

If you have any doubts, it is better to call and consult with the operating surgeon.

Before which procedures and manipulations is it not necessary to take antibiotics?

Before routine smears, blood tests, blood donations, eye surgery (if the cause is not an infection), and removal of moles.

Will there be any problems when passing through a metal detector at the airport?

There are chances that the metal detector will react to your prosthesis. It may take a few extra minutes to check, since joint replacements are quite common, the airport security will deal with this situation quite quickly. If you are planning a trip, you must have a photocopy of the discharge summary with you.

Can I have an MRI exam?

Yes. The metal that is currently used in the manufacture of prostheses allows for MRI examinations.

What is the success rate of arthroplasty surgery?

More than 95% of patients are satisfied with the results of the operation, and they have returned to their normal lifestyle. The service life of the hip endoprosthesis is more than 20 years, the knee joint is more than 15 years, provided that the recommendations are strictly followed in the postoperative period.

How long will it take me to recover after such an operation?

The recovery period depends on many factors, gender, your age and your health. Usually walkers or crutches are used during the first month, followed by a transition to a cane. Patients use a cane until they feel confident walking. On average, after 3 months you will be able to return to your normal lifestyle.

When can I return to work?

If you spend most of your time at your desk, you can start it in 6 weeks. This usually resolves after the first follow-up visit to the doctor after surgery. If you need to move a lot at work (walk, stand, bend over), then most likely you will be able to return to work in 3 months, this issue will be resolved by your surgeon before the sick leave is closed.

What are "artifacts" on MRI scans?

Artifacts (from Latin artefactum) are errors made by a person in the process of research. Artifacts significantly degrade image quality. There is an extensive group of physiological (in other words, related to human behavior) artifacts: motor, respiratory, artifacts from swallowing, blinking, random uncontrolled movements (tremor, hypertonicity). All artifacts associated with the human factor can be easily overcome if a person is completely relaxed during the study, breathes evenly and freely, without deep swallowing movements and frequent blinking. However, in medical practice, cases of using light anesthesia are not uncommon.

At what age can children have an MRI?

Magnetic resonance imaging has no age restrictions, so it can be carried out to children from birth. But due to the fact that during the MRI procedure it is necessary to remain still, the examination of young children is carried out under conditions of anesthesia (surface anesthesia). In our center, examination under anesthesia is not carried out, therefore, we examine children only from the age of seven.

What are the contraindications for MRI?

All contraindications to MRI can be divided into absolute and relative.
Absolute contraindications for MRI are the following features of the patient: the presence of a pacemaker (heart pacemaker) and other implantable electronic devices, the presence of ferrimagnetic (iron-containing) and electrical stapes prostheses (after reconstructive operations on the middle ear), hemostatic clips after operations on the vessels of the brain, abdominal cavity or light, metal fragments in the orbit, large fragments, shot or bullets near the neurovascular bundles and vital organs, as well as pregnancy up to three months.
Relative contraindications include: claustrophobia (fear of closed space), the presence of massive non-ferrimagnetic metal structures and prostheses in the patient's body, the presence of an IUD (intrauterine device). In addition, all patients with magnetically compatible (not ferrimagnetic) metal structures can be examined only after a month after the surgical intervention.

Do I need to have a doctor's referral to get an MRI?

A doctor's referral is not a prerequisite for visiting an MRI center. Your concern for your health, your consent to the examination, as well as the absence of contraindications for an MRI is important to us.

I get headaches often. Which area should have an MRI?

Any person is familiar with a headache, but if it recurs suspiciously often, of course, this cannot be ignored. We recommend that a patient with severe headaches undergo an MRI of the brain and its vessels. In some cases, this may not be enough, because the cause of headaches is not always associated with the pathology of the brain. Headaches may be the result cervical osteochondrosis Therefore, our specialists additionally advise to undergo an MRI cervical spine and neck vessels.

How long does an MRI exam take?

Average duration one study in our center is from 10 to 20 minutes, however, it all depends on the identified changes: sometimes, to clarify the disease, the radiologist can expand the study protocol and resort to the use of contrast enhancement. In such cases, the study time is increased.

In the human musculoskeletal system, the knee joint is the most overloaded. Often, it accounts for the bulk of the body, so it is more vulnerable to disease and more likely to be destroyed.

Under the influence of age and various factors (ruptures of the inner meniscus of the knee, trauma, infectious and inflammatory processes, hypothermia), the cartilage tissue becomes thinner, and the end bones begin to rub against one another. This provokes injuries, limits movement in the joint and causes excruciating pain to a person.

If conservative methods of treatment are no longer able to cope with the problem, doctors offer the patient a knee replacement.

The operation is indicated in the following situations:

• the presence of arthrosis, that is, degenerative-dystrophic diseases of the joint;
• rheumatoid arthritis;
• post-traumatic abnormal fusion of the bones included in the knee joint.

The endoprosthetics operation lasts an average of 2 hours. The patient is given general anesthesia or a nerve block is produced, which within 24 hours after surgical intervention continues to relieve pain.

To penetrate into the joint, an incision is made above it, the patella is carefully moved to the side. The doctor removes excess bone formations formed as a result of rubbing the end bones against each other. These growths are a kind of protective reaction of the body.

In addition, the surgeon loosens the tension of the periarticular soft tissues, which returns diarthrosis to its original state.

The worn-out remnants of cartilage tissue are carefully cut off, and a perfectly fitted prosthesis is implanted in its place. Moreover, the end bones are covered with special metal nozzles:

1. a titanium plate is placed on the tibia;
2. on the femur - an anatomically adapted prosthesis.

Additional inserts are attached to the titanium plate to ensure smooth movement in the joint. A special bone cement is used to fix the knee joint prosthesis. In some cases cementless fixation is used. The operated joint is then sutured and immobilized with a plaster cast or splint.

The operation to replace knee diarthrosis provides the patient with complete freedom of movement and relief from excruciating pain in the future.

Advantages and disadvantages of prosthetics

Endoprosthetics knee joints has its advantages and disadvantages. The absolute advantages include the disappearance of pain and lameness, the return of the joint to full functionality.

The negative factors of arthroplasty include the likelihood of infection, although statistics state that the percentage of probability of such a course of events is very low.

Rehabilitation after arthroplasty takes a rather long period of time - about two months. During this time, the patient must get used to the prosthesis and learn how to freely manage it.

Many doctors are supporters of arthroscopy - this is an operation with minimal trauma. In addition, recovery after arthroscopy occurs much faster than after conventional prosthetics.

It is indicated for minor injuries in the joint, when the restoration of cartilage tissue in the knee is still possible by taking special medicines and a range of other activities.

During arthroscopy, the doctor:

1. right dislocation;
2. removes bone growths;
3. relieve tension in the muscles around the joints.

In the case when the cartilage tissue is damaged thoroughly, this operation provides only temporary relief.

It is not uncommon for patients who have undergone knee replacements to panic when the prosthesis is wedged. Unfortunately, this situation is not excluded and it is due to the improper functioning of the periarticular muscles.

If pain appears, it cannot be tolerated, you should try to take the most comfortable position and try to move your leg. If the jamming has not disappeared, then you need to contact an orthopedist. The situation is quite fixable and is not critical.

After surgery, there is a possibility of thrombosis and inflammation in the articular tissues. Therefore, the patient must first weigh all the pros and cons that prosthetics entail.

Endoprosthetics of the knee joint is categorically contraindicated for people suffering from cardiovascular pathologies and chronic joint infections.

What not to do after arthroplasty

- the process is quite lengthy. However, the patient can take the first steps after 2-3 days. Sports activities after knee arthroplasty are allowed only after a few months, and you must first consult with your doctor and get his approval.

You will have to forget about big sport after arthroplasty forever. However physiotherapy not only not prohibited, but also recommended. It is necessary for the development of the knee joint from the first days of recovery.

Physiotherapy procedures during knee replacement are prohibited in the first months, and in the future they are also undesirable. Because of the metal elements, magnetic resonance therapy can cause intense pain and tissue damage around the prosthesis.

Warm baths, saunas, baths and massages in the first months after prosthetics are also prohibited. These activities increase the likelihood of thrombosis. The diet for patients with an endoprosthesis should be sparing and consist of:

• lactic acid products;
• jelly.

After implantation of a knee joint endoprosthesis, a person can perform almost all the same actions that were available to him before the replacement of the joint.

But still there are some limitations. For an artificial joint, the following actions are unacceptable:

1. excessive loads;
2. squats with weight;
3. running on sloping and uneven roads.

Rehabilitation after prosthetics

Rehabilitation of knee joints takes different periods of time for different people. Some patients walk well within a week, while others take several months to fully recover.

Properly selected physical activity is necessary to ensure that the joint becomes accustomed to the endoprosthesis and that it becomes overgrown with muscles. Rehabilitation of the patient in a special sanatorium-resort institution is recommended, where he will receive a full recovery complex of procedures and measures.

Under the supervision of medical staff and in a comfortable relaxing environment, the patient:

• take a course of physiotherapy exercises;
• take mineral baths;
• will swim in the pool;
• will receive proper nutrition in the canteen.

Therapeutic exercises after knee prosthetics are performed by the patient from the first days of recovery. At first, the movements should be light and gentle, but over time, the doctor will create an individual complex consisting of muscle stretching, exercises to strengthen the gluteal muscles and the inner surface of the thigh.

At first, gymnastics is performed only while sitting or lying down. However, when the joint is fully restored, and inflammatory process standing and walking exercises are absent. Aqua aerobics and swimming provide excellent results, but these activities must be approved by a doctor.

Knee arthroplasty provides the patient with the opportunity to return to a full life and feel free to move, and not a disabled person, immured in his own body.