Pathologic evaluation of the failed cup arthroplasty: a review of 32 cases

Thirty-one specimens of femoral heads from failed arthroplasty operations were analyzed. One hip joint from autopsy was also reviewed. Cup arthroplasty does not lead to the formation of hyaline cartilage and sometimes not even fibrocartilage. Fibrous tissue rather than fibrocartilage lined the interspace between femoral head and cup in the majority of cases. There was frequent resorption of subchondral bone, and avascular necrosis of the bone inside the cup. Osteoarthritis and progressive femoral head degenerative bone changes generally continued despite surgical reaming and removal of all articular cartilage.