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Radiology of failed surface-replacement total-hip arthroplasty
AJR. American Journal of Roentgenology
|December 1, 1982
Summary
Radiographs and bone scans help identify loosening in failed total-surface hip replacements. Subtle signs like abnormal cup alignment or increased bone scan activity indicate potential issues.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomaterials
Background:
- Total-surface hip replacement (TSHR) is an alternative to conventional total hip arthroplasty.
- Assessing TSHR component loosening presents unique radiographic challenges.
- Surgically confirmed failures provide a basis for evaluating diagnostic methods.
Purpose of the Study:
- To review radiographic and bone scan findings in failed TSHR.
- To identify key indicators of acetabular and femoral component loosening.
- To establish guidelines for evaluating TSHR failures.
Main Methods:
- Review of radiographs, arthrograms, and bone scans in 23 patients with failed TSHR.
- Correlation of imaging findings with surgical confirmation of component loosening.
- Analysis of radiographic signs of loosening for both acetabular and femoral components.
Main Results:
- Acetabular component evaluation follows conventional total arthroplasty guidelines.
- Femoral component loosening signs include abnormal cup alignment and positional changes on serial radiographs.
- Increased bone scan activity at the cup base suggests loosening or infection, despite potential visualization obstruction.
Conclusions:
- Radiographic assessment of TSHR loosening requires attention to subtle signs.
- Bone scans can be valuable in detecting femoral component loosening and infection.
- Standardized evaluation protocols are crucial for managing failed TSHR cases.