Complications of hip arthroplasty causing periprosthetic radiolucency on plain radiographs

The technique of hip arthroplasty is at least 30 years old and currently is performed 120,000 times per year in the United States [1]. Changes in materials and surgical techniques have markedly decreased the prevalence of infection and aseptic loosening. At the same time, other complications such as stress shielding and aggressive granulomatosis have become increasingly important complications of joint replacement [2]. All four of these entities manifest radiographically as periprosthetic lucency (Fig. 1.). The purpose of this essay is to illustrate the plain film findings of each of these complications.