Clinical implementation of MRI for evaluation of titanium press-fit osseointegration implants.

Objective: This investigation of the safety of titanium transcutaneous osseointegrated nail (TiTON) implants in a magnetic resonance imaging (MRI) suite evaluated whether any adverse events occurred for patients (pain, heating sensation, implant loosening, and delay in care) or for the MRI machine (device damage). Design: Retrospective chart review. Setting: Academic medical center specializing in musculoskeletal health in Manhattan. Patients/Participants: Patients who had osseointegration surgery underwent retrospective chart review and were also contacted inquiring whether they had subsequent MRI to any body part. Thirty-four patients had 51 total MRI scans: 24 of the osseointegrated limb and 27 of other anatomy. Intervention: 1.5T or 3.0T MRI after TiTON implantation. Main Outcome Measurements: Patients were asked if any adverse experiences such as pain, heating sensation, or implant loosening occurred. All original MRI and reports were sought to evaluate for evidence of adverse patient or machine events. Results: No patients had any recognizable adverse event associated with MRI, including specifically pain, heating sensation, or implant loosening. No evidence of adverse machine interaction could be identified. Conclusions: MRI is safe for patients with press-fit TiTON implants. To optimally ensure safety, osseointegrated patients seeking MRI should confirm with their implant company that no nontitanium components might be part of their total prosthesis construct and confirm they have no after-market modifications that may be ferromagnetic, such as screws or clamps.