Radiology of failed surface-replacement total-hip arthroplasty.
The radiographs, arthrograms, and bone scans in 23 patients with surgically confirmed failed total-surface hip replacement were reviewed. Guidelines for evaluation of the acetabular component are identical to those for conventional total arthroplasty. The femoral component of a surface-replacement total hip arthroplasty consists of a metallic cup affixed to a resurfaced femoral head with interposed methyl methacrylate. Because of bone-acrylic interface is obscured by the metallic cup, the radiographic features of loosening are limited to an abnormal alignment of the metallic cup in relation to the femoral neck or a change in the position of the cup in serial radiographs. These signs may be subtle. While the metallic cup may often prevent visualization of underlying isotope activity at the bone-acrylic interface, increased activity at the base of the cup when identified suggests loosening or infection.
D000077:Acetabulum / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005265:Femoral Neck Fractures / Q000209:etiology; D005270:Femur Head / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010020:Osteonecrosis / Q000601:surgery; D011859:Radiography; D011877:Radionuclide Imaging; D013997:Time Factors