Loosening of the femoral component after total hip replacement. The thin black line and the sinking hip.
Review of the radiographs of 882 consecutive metal-to-polyethylene hip replacements after a mean follow-up of 6.8 years showed 72 cases (8%) of aseptic femoral loosening, all of which showed a lucent zone or black line between metal and cement. In 97% of the series this appeared within two years of the arthroplasty. Progress of loosening was unpredictable and only 24% had significant symptoms. Improved technique with methylmethacrylate cement in Stanmore prostheses had reduced loosening after two years from 7.9% to 0.4%. Methods of detection of early loosening are discussed.
D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011475:Prosthesis Failure; D011859:Radiography; D013997:Time Factors