White TO, Dougall TW (2002) Arthroplasty of the hip. Mulhall KJ, Masterson E, Burke TE (2004) Routine recovery room radiographs after total hip arthroplasty: ineffective for screening and unsuitable as baseline for longitudinal follow-up evaluation. Manaster BJ (1996) From the RSNA refresher courses: total hip arthroplasty-radiographic evaluation. doi: 10.1136/bmj.c2332Ĭharnley J (1961) Arthroplasty of the hip: a new operation. Hopley C, Stengel D, Ekkernkamp A et al (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. Pivec R, Johnson AJ, Mears SC, Mont MA (2012) Hip arthroplasty. Sonography is not ideally suited to evaluate the prosthesis and periprosthetic bone because of the inability of ultrasound beams to penetrate metal or bone.Ĭenters for Disease Control and Prevention (2010) National hospital discharge survey: 2010 table, procedures by selected patient characteristics. Multidetector CT induces a higher patient radiation exposure compared to conventional radiography. Artefacts still hamper MR image quality and image interpretation, although sequence modification has been shown to allow for evaluation of the bone-prosthesis interface and the surrounding soft tissues. Although cross-sectional studies may have an important role in evaluating and characterizing abnormalities of periprosthetic bone and juxta-articular soft tissues, they usually come at an increased cost. Despite the widespread use of MRI, CT, and sonography in joint imaging, the postoperative radiograph remains the keystone in the assessment of hip arthroplasty, as it is readily available at a low cost, with no metal artefact, and facilitating longitudinal comparison. Since the revolutionary development in the field of hip implants, made by Charnley in the 1960s, surgical techniques and the design of implants as well as the imaging modalities have evolved significantly. The choice whether to replace a fractured hip with a total hip arthroplasty or a hemiarthroplasty (in which the native acetabulum is spared) remains a topic of an ongoing debate. Total hip arthroplasty is most commonly performed for treatment of osteoarthritis. It has been described as one of the most overall successful orthopedic procedures, allowing for early weight bearing and mobilisation, resulting in pain relief, restoration of function, and improved quality of life for many patients. Hip arthroplasty is one of the most common procedures performed for the treatment of advanced osteoarthritis and is also a required in approximately one-third of hip fracture patients, with 332,000 hip replacements performed in 2010 in the United States. To discuss radiographic findings of the most common complications.To provide a simple framework for a systematic approach to postoperative radiographs.To give an overview of the different types of currently used hip arthroplasties.Complications can be classified in three major groups: periprosthetic lucencies, sclerosis or bone proliferation, and component failure or fracture. Additional orthogonal views may be useful to evaluate acetabular anteversion. After identification of the type of arthroplasty, meticulous and systematic analysis of the following parameters on an anteroposterior standing pelvic radiograph should be undertaken: leg length, vertical and horizontal centre of rotation, lateral acetabular inclination, and femoral stem positioning. Knowledge of the different types of hip arthroplasty and fixating techniques is a prerequisite for correct imaging interpretation. Currently, there is a plethora of commercially available arthroplasties, making postoperative analysis not always straightforward.
This pictorial review aims to provide the radiologist with simple and systematic guidelines for the radiographic evaluation of a hip prosthesis.
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