Because component failure may have a protracted subclinical course, detecting any findings of malfunction relies heavily on routine radiographic assessment these findings may be subtle, so a high index of suspicion is crucial. Detecting complications after arthroplasty is the result of thorough clinical investigation, history taking, examination, and judicious use of supportive radiologic and laboratory studies. Given sufficient time, all prostheses eventually fail. The specific type of prosthesis, surgical technique, and surgeon-related and patient-related factors play a role in the relative frequency with which complications occur. Although the types of prostheses continuously evolve, hip prostheses may be divided simply into unipolar, bipolar, and total arthroplasties, with the last divided further by bearing surface (metal on polyethylene, metal on metal, ceramic on ceramic, and ceramic on polyethylene). The high prevalence of hip pathology and the broad success of hip replacement surgery have resulted in hip arthroplasty becoming a routine procedure, with an estimated 170,000 primary hip arthroplasties performed annually in the United States and approximately 35,000 revision surgeries performed as revision surgery. More sophisticated imaging and image-guided interventions may then be used to determine the cause of failure, primarily to exclude sepsis. In a postarthroplasty patient, subtle changes may often be indicators of loosening and hardware failure. The relative ease of radiographic comparison allows for more accurate monitoring of disease progression. Cross-sectional imaging may be used for disease confirmation and determination of severity and extent. Together with the clinical evaluation and laboratory studies, radiographic evaluation serves as the first line of investigation of any hip pain, providing an overall view of the hip joint. doi:10.7863/jum.2012.31.2.Radiographic evaluation of the hip before and after arthroplasty is the cornerstone of radiologic assessment. Common Sonographic Findings in the Painful Hip After Hip Arthroplasty. Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society. Healy W, Iorio R, Clair A, Pellegrini V, Della Valle C, Berend K. Postoperative Radiograph of the Hip Arthroplasty: What the Radiologist Should Know. Vanrusselt J, Vansevenant M, Vanderschueren G, Vanhoenacker F. Management of Periprosthetic Joint Infections (PJIs). The Accuracy of Imaging Techniques in the Assessment of Periprosthetic Hip Infection: A Systematic Review and Meta-Analysis. Dislocation Following Total Hip Replacement: The Avon Orthopaedic Centre Experience. Blom A, Rogers M, Taylor A, Pattison G, Whitehouse S, Bannister G. Complications of Hip Arthroplasty Causing Periprosthetic Radiolucency on Plain Radiographs. Keogh C, Munk P, Gee R, Chan L, Marchinkow L. This enables consistent standardized reporting of complications 8. deep vein thrombosis and pulmonary embolismĪ standardized list of complications post total hip arthroplasty was developed by consensus by The Hip Society. General post-orthopedic surgical complications Polyethylene wear eccentric position of the femoral head component within the acetabular componentĪseptic lymphocyte-dominant vasculitis-associated lesion (ALVAL)Ībductor muscle/tendon dysfunction e.g. Particle disease / histiocytic reaction / aggressive granulomatosisĭislocation of femoral head out of the cup: component dissociation Complications following hip arthroplastyĬomplications of total hip arthroplasty are common and it is essential for the radiologist to be aware of them in the assessment of radiographs of total hip replacements. Complications are many and can occur at various time intervals following the initial surgery:Īseptic loosening: considered to be the most common indication for revision surgery 1,2,4.Complications following hip joint replacements.Complications of hip joint replacements.Post-surgical complications of total hip arthroplasty.Post-surgical complications of total hip replacement.Postoperative complications of total hip arthroplasty. Postoperative complications of total hip replacement.Post-operative complications of total hip arthroplasty.Post-operative complications of total hip replacement.Complications post hip joint replacements.
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