A method for the postmortem evaluation of an in situ total hip replacement

A method was developed for the post-mortem evaluation of a total hip replacement retrieved in situ. The hip replacement had been implanted for six years. The evaluation procedure employed existing techniques in a logical sequence such that earlier tests would not compromise results from subsequent ones. These techniques included the measurement of range of motion, aspiration of the joint for analysis of debris, radionuclide arthrograms for determination of looseness of the components, gross and histological inspection of the capsule and synovial tissue, serial sectioning of the femoral component, determination of some mechanical properties of the bone and femoral stem, and scanning electron microscopy of the articulating surfaces of the prosthetic components. Positive findings in the specimen studied were: excessive wear of the articulating surface of the acetabular component, and associated polyethylene debris in the aspirate and surrounding synovial and granulation tissue.