X-ray of a loose total hip replacement prosthesis ..
An X-ray showing a right hip ..
Hip Replacement X Ray | Doctor of Orthopedic
A fracture may occur to the tube-like femur bone within which is fixed the femoral prosthesis with either bone cement or biologic attachment, or to the supporting bone of the pelvis to which is fixed the acetabular prosthesis. There is a wide variety of fracture patterns which occur, each having many possible solutions. A patient’s age, activity level and overall health will be weighed along with the various options to repair a fracture around a hip replacement.
The most common situations that lead to the need for a revision hip replacement are instability / dislocation, mechanical loosening and infection. According to one national review study, instability issues account for 22% of all revision hip replacements, aseptic loosening for 20% and infection the cause of 15% of yearly revision hip replacement surgeries . Periprosthetic fracture, component failure and osteolysis-related wear are the causes for the remaining revision hip replacements done each year. Of great concern looking forward is that infection by the year 2030 will account for 48% of all revision hip replacements that will be done . This has grave economic implications as infection is one of the most expensive complicating events related to joint replacement surgery.
Fixation and loosening of hip prostheses
About one in fifty hip replacements dislocate, which occurs when the ball comes out of the socket. Most dislocations occur during the first month after surgery; in some patients this can become a recurring problem. Dislocated hips are obvious; the dislocation occurs suddenly, often while the hip is flexed, and the leg is painfully stuck in one position. Often the leg appears shorter. The sudden, severe pain and inability to move are obvious signs of a problem, and the diagnosis is easily made in the emergency room by taking an X-ray of the hip. Treatment is immediate relocation of the hip under anesthesia. Patients that experience recurrent dislocations require careful evaluation to determine the reasons why the joint is unstable. Surgery to correct recurrent dislocation is warranted when a correctable mechanical cause can be identified.
In assessing a hip for infection several steps may be needed as the diagnosis of an infection can be elusive. Plain X-ray studies can occasionally be helpful with observed changes at the interface of the bone and metal implant. Various studies including MRI, CT and bone scans may be needed in addition to plain X-rays to assess the character and integrity of the supporting bone. Laboratory studies are frequently collected from the blood and fluid taken from the hip joint in an attempt to validate or refute the diagnosis of a joint infection.
X-Ray | Investigations For Hip & Knee Pain | CT Scan
In all of these cases the resultant structural bone defect must be reconstructed. Sometimes smaller defects can be ignored and the new implants are chosen to bypass the weakened area, being fixed to a more solid part of the bone. Other times processed bone graft or even large pieces of bone are required to fill in defects for more biologic support. Large pieces of bone must often be shipped in prior to surgery and thus the preoperative planning for this need is just one of the many things the surgeon must anticipate for these complex reconstructions. In many large teaching hospitals, a bone bank is kept on the premises and bone graft is readily available during surgery.
In conjunction with the reconstruction of any bone defects, the surgeon will need to determine which of the many revision prostheses available is right for the current situation. In most systems used today for this type of surgery, manufacturers of these implants have multiple and variable attachments to the implants which allow the surgeon to create the tightest and most stable construct possible while maximizing the normal motion of the hip.
Flexor Retinaculum Foot with Bone Scan Hip Prosthesis Loosening …
Loosened hip replacement, X-ray - Stock Image …
Hip Replacement X Ray
is performed when X-ray studies show loosening of the prosthesis, ..
HIP X-RAY ..
In this x-ray of a normal hip, ..
Compare Low Back Pain X Ray Best Hip And Lower Back Stretches Muscles That Can ..
X-ray of areas affected by hip ..
Stabilizing a complex fracture of the femur or acetabulum while providing a hip replacement that will be stable, support weight and hold up to normal activities is among the most challenging of reconstructive surgeries undertaken by the surgeon. Poor bone quality, advanced age of the patient and lengthy surgical times are common obstacles faced by the surgeon when planning treatment for these difficult situations. Persistent instability of the hip joint and chronic pain problems are not uncommon after this type of revision hip replacement surgery. This can be very difficult surgery for even the most experienced surgeon and is often referred out to tertiary care and teaching facilities.
The Radiology Assistant : Hip - Arthroplasty
44 years old male presented to our Hospital with complaints of pain over Right Hip for 6 years.
He had undergone Total Hip Replacement for his Right hip 10 years back elsewhere.
We did a X-RAY ,which showed prosthesis loosening and bone defects both in Right hip and Thigh bones.
CT SCAN revealed massive defect both in Hip and Thigh bones
01/02/2006 · Chest X-Ray - Basic ..
The prevailing principal in dealing with any fracture around the hip is to gain stability of the fracture and then gain stability of the hip replacement. Both the bone and the prosthesis must be stable to allow any weight bearing. It is rare that full weight bearing is allowed before the fracture is healed. In addition, if the prosthesis comes loose from the fractured bone the surgeon will typically try to bypass the fractured area of the bone to obtain firm fixation on bone further down the shaft. On very rare occasions it may be necessary to replace most of the shattered femur with a very large hip replacement prosthesis referred to as an oncologic prosthesis, one that is used in cases where a tumor has destroyed the bone.
Mechanical loosening presents as diffuse lucency
A 64-year-old Caucasian woman was referred to our hospital with a 3-year history of bilateral hip pain. 2 years prior, the patient had been diagnosed with a GH-producing pituitary adenoma and treated in 2008 by transsphenoidal surgery without radiation. Post-operative follow-up revealed a poor control of GH levels. At the time, she was treated with the administration of octreotide acetate (30 mg/month) (Sandostatin LAR, Novartis Pharma, Tokyo, Japan). On physical examination, the patient’s height and weight were 168.2 cm and 57 kg, respectively. Her blood pressure was 145/109 mmHg. Typical acromegalic features, including enlargement of the nose, lips, tongue, and extremities, were observed; however, no cushingoid features, such as central obesity, moon face, and buffalo hump, were present. Range of motion of both hips was limited in every direction. The startup test was painful, and a slight Trendelenburg gait was observed. Standard X-rays revealed a bilateral narrowing of the joint space, osteophytes, and slight sclerosis, corresponding to Kellgren and Lawrence Grade 2 hip osteoarthritis (Fig. 1). As the 6-month conservative treatment with non-steroidal anti-inflammatory acetaminophen and physiotherapy failed to improve symptoms, bilateral THA was proposed. The right hip was operated on in December 2008 and the left hip in January 2009. An uncemented, double-tapered, fully hydroxyapatite-coated stem (quadra H reg, Medacta, Castel San Pietro, Switzerland) with a modular neck and ceramic head with a 28-mm articulation was implanted through a direct anterior approach on a specialty orthopedic traction table. The acetabular component was an uncemented, porous cup with a ceramic insert (Versafit Cup CC, Medacta SA, Castel San Pietro, Switzerland).
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