Learning objectives
This pictorial essay will demonstrate the common complications post total hip arthroplasty.
We broadly categorize them into
Immediate post-operative complications.
Medium to long term complications.
The best imaging modality to assess the complications.
Challenges related to the diagnosis of complications.
Background
The low friction arthroplasty developed by Chanley has progressed in design,
operative techniques and clinical applications over the last 50 years.
It is one of the most common surgical procedures performed in UK emphasizing the importance of assessing potential complication by radiologists.
The various complications following arthroplasty include aseptic loosening,
particle disease (osteolysis),
infection,
component wear,
dislocation,
fracture,
heterotopic ossification,
metal-induced reactive mass (pseudo tumour/ALVAL),
abductor muscle tear,
iliopsoas impingement and muscle atrophy.
Imaging findings OR Procedure Details
Instability and Dislocation:
This is the most common complication leading to revision hip arthroplasty.
The incidence ranges from 0.3% to 10% after primary and 10% -28% after revision hip arthroplasty.
Posterior dislocation is more common than anterior with trauma and poor muscle tone as a risk factor.
Mal position of the surgical implant is an important surgical factor.
Plain radiograph is the investigation of choice and often occurs in the immediate post op period due to haematoma or a few years after the surgery due...
Conclusion
Awareness of the potential complications following THR and challenges presented by painful THR helps radiologist to choose appropriate investigation for making the diagnosis.
This will aid the Orthopaedic surgeons in the management of complex cases.
References
Imaging Evaluation of Complications of Hip Arthroplasty: Review of Current Concepts and Imaging Findings.
Omer Awan,
Lina Chen,
Charles S.
Resnik,
Canadian Association of Radiologists Journal 64 (2013) 306-313
Complications of hip arthroplasty causing periprosthetic radiolucency on plain radiographs.
Tigges S,
Stiles RG,
Roberson JR.
AJR Am J Roentgenol 1994;162:1387-91.
The reliability and validity of the Vancouver classification of femoral fractures after hip replacement.
Brady OH,Garbuz DS,Masri BA,Duncan CP.
J Arthroplasty.2000 Jan;15(1):59-62.
Heterotopic ossification.
Shehab D,
Elgazzar AH,
Collier BD.
J Nucl Med 2002;43:346-53.
A...