Sunday, May 29, 2011

Interesting X rays of hip issues with Artheroplasty

I thought these radiograph  were interesting and show the issues with these implants if they fail. They look like radiographs from the Hospital of Special Surgery in NYC.  They were published on Parker Waichman's site.
Wear of hip implant with pieces of broken material in tissue. Broken head of hip implant (upper left) and pieces of broken ceramic material embedded into tissue (lower right) due to wearing of hip implant which may lead to Osteolysis and bone breakage.
Wear of hip implant with pieces of broken material in tissue.
Failed total hip replacement with revision. 1. Patient with a failed total hip replacement with considerable proximal femoral bone loss, proximal migration of the greater trochanter and breakage of multiple screws distally from the previous interlocking device.
2. Surgeons revised the hip implant with a constrained acetabular component and cemented a proximal femoral replacement into the distal femur.
Failed total hip replacement with revision.
Wear of the acetabular liner of hip implant. 1. A radiograph of the pelvis demonstrates area of wear of the acetabular liner, with superolateral displacement of the femoral head (red arrow). Large radiolucent area superior to the acetabular companent (yellow arrow), and bony resorption of the proximal medial femur adjacent to the insertion site of the femoral prosthetic companent (green arrow).
2. Changes not seen in first film.
Wear of the acetabular liner of hip implant.

Hip Implant Revision
1. Loose total hip replacement
2. Right hip revision hip replacement to correct loosened hip implant.

Hip implant revision. Loose total hip replacement

Osteolysis bone loss disease 
1. Osteolysis involves wear particles (worn off the contact surface of the artificial ball and socket joint). As the body attempts to clean up these wear particles (typically consisting of plastic or metal) it triggers an autoimmune reaction which causes resorption of living bone tissue. Osteolysis has been reported to occur as early as 12 months after implantation and is usually progressive. This may require a revision surgery (replacement of the prosthesis).
2. Aseptic loosening of a hip implant. Note the radiolucencies next to the implant, a result of osteolytic bone loss.

Osteolysis bone loss disease


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