Developments in diagnosis of the painful total hip replacement

There has been significant improvement in the interpretation of diagnostic tests for the evaluation of the cemented and uncemented symptomatic total hip replacement. Lucent lines around cemented implants have often been found to represent remodeling rather than loosening. Lysis without looseness has been described as a cause of hip pain in both cemented and uncemented hip replacements. Therefore, there are a number of recent developments in diagnosis that must be considered when evaluating the symptomatic cemented or cementless total hip replacement. Some of these developments are reviewed in this paper. Other developments and contemporary algorithms for treatment incorporating these recent data will be presented in next month's issue.