[Surgical techniques used in the revision of hip prostheses]

The most common cause of failure of cemented and cementless total hip arthroplasties is aseptic loosening, a slow but progressive process that often results in loss of bone stock. The diagnosis of loosening of the prosthetic component is difficult and depends mainly on migration and change in position of the prosthesis and the appearance of clear zones around the prosthesis on X-ray photographs. The key problem in revision surgery is how to manage the periprosthetic bone loss. Controversy exists about the best treatment for bone stock defects. The various techniques are directed at restoration of the hip mechanics, restoration of the defects in the osseous wall, replacement of the resorbed bone and thus restoration of the functional stability of the joint.