Imaging of the Painful Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomaterials Science

Background:

• Total hip arthroplasty (THA) is a common procedure with a low complication rate.
• However, the high volume of THA means complications are frequently encountered.
• These complications can lead to significant patient morbidity and require accurate diagnosis.

Purpose of the Study:

• To review the spectrum of complications following total hip arthroplasty.
• To illustrate key imaging findings associated with each complication.
• To outline a systematic approach for radiological investigation of THA complications.

Main Methods:

• Review of relevant literature on THA complications and their imaging.
• Illustration of characteristic imaging findings for various complications.
• Development of a practical radiological investigation pathway.

Main Results:

• Common complications include aseptic loosening, infection, osteolysis, adverse metal reactions, periprosthetic fracture, heterotopic ossification, hardware failure, and soft tissue issues.
• Different imaging modalities (e.g., X-ray, CT, MRI, ultrasound) play specific roles in diagnosis.
• A structured approach aids in efficient and accurate identification of complications.

Conclusions:

• Prompt and accurate radiological investigation is crucial for managing total hip arthroplasty complications.
• Understanding imaging features and employing a systematic approach improves diagnostic yield.
• This review provides a guide for radiologists and orthopedic surgeons managing post-THA complications.