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The metal-cement interface in total hip prostheses.

A A DeSmet, D Kramer, W Martel

    AJR. American Journal of Roentgenology
    |August 1, 1977
    PubMed
    Summary
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    Lucent zones at the femoral metal-cement interface in total hip arthroplasties are often not indicative of infection or loosening. Careful clinical evaluation is warranted for progressive or wide lucent zones, but their presence alone does not necessitate complications.

    Area of Science:

    • Orthopedic Surgery
    • Radiology
    • Biomedical Engineering

    Background:

    • Radiographic assessment is crucial for evaluating total hip arthroplasties (THAs).
    • Lucent zones at the femoral metal-cement interface are a potential radiographic finding.
    • The clinical significance of these lucent zones requires further investigation.

    Purpose of the Study:

    • To assess the clinical significance of lucent zones at the femoral metal-cement interface in THAs.
    • To determine the correlation between lucent zones and complications such as infection or loosening.

    Main Methods:

    • Review of serial radiographs from 101 total hip arthroplasties.
    • Identification and measurement of lucent zones at the femoral metal-cement interface.
    • Clinical follow-up of patients with identified lucent zones.

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  • Microdensitometry to confirm the nature of the lucent zones.

    • Main Results:

    • Lucent zones were identified in 19 out of 101 THAs.
    • Only 4 cases showed clinical evidence of infection or loosening associated with lucent zones.
    • 15 prostheses with lucent zones were followed for 18 months to 5 years without complications.
    • Microdensitometry confirmed true lucent zones in most cases, with some attributed to the Mach effect.

    Conclusions:

    • The presence of lucent zones at the femoral metal-cement interface does not invariably indicate infection or loosening.
    • Progressive widening or lucency >2 mm warrants careful clinical evaluation for potential complications.
    • Many lucent zones can be present without adverse clinical outcomes in THAs.