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Complications of total hip arthroplasty

Last revised by Rohit Sharma ◉ on 25 Jul 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Sharma R, Elfeky M, et al. Complications of total hip arthroplasty. Reference article, Radiopaedia.org (Accessed on 21 Jan 2025) https://doi.org/10.53347/rID-18920

DOI:

https://doi.org/10.53347/rID-18920

Permalink:

https://radiopaedia.org/articles/18920

rID:

18920

Article created:

27 Jul 2012, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

25 Jul 2024, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

42 times, by 20 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Gamuts

Tags:

hip, arthroplasty, orthopaedics

Synonyms:

Complications of hip arthroplasty
Complications of hip prosthesis
Complications of hip arthroplasties
Complications of hip prostheses
THR complications
Complications post hip joint replacements
Complications following THRs
Complications following THA
Complications following THAs
Complications following THR
Sequelae of total hip arthroplasty
Sequelae of total hip replacement
Post-operative complications of total hip replacement
Post-operative complications of total hip arthroplasty
Postoperative complications of total hip replacement
Postoperative complications of total hip arthroplasty
Post-surgical complications of total hip replacement
Post-surgical complications of total hip arthroplasty
THA complications
Complications of hip replacements
Sequelae of total hip replacements
Sequelae of total hip arthroplasties
Complications of hip joint replacements
Complications following hip joint replacements
Complications following hip arthroplasty

Complications of total hip arthroplasty are common and the radiologist needs to be aware of them in the assessment of radiographs of total hip replacements. Complications are many and can occur at various time intervals following the initial surgery:

aseptic loosening: considered to be the most common indication for revision surgery ^1,2,4
infection of hip prostheses ^5,6
particle disease / histiocytic reaction / aggressive granulomatosis
fracture
dislocation (~5% of all replacements ⁴)
- dislocation of femoral head out of the cup: component dissociation
- dislocation of the entire acetabular cup
- dislocation of stem
malpositioning
- creep: can lead to protrusio acetabuli
- intrapelvic cup migration
- polyethylene wear eccentric position of the femoral head component within the acetabular component
heterotopic bone formation
reaction to metal
pseudobursae formation ²
abductor muscle/tendon dysfunction e.g. tears
stress shielding
trochanteric bursitis
revision total hip arthroplasty
general post-orthopedic surgical complications
- hemorrhage
- wound complications e.g. dehiscence
- thromboembolism, e.g. deep vein thrombosis and pulmonary embolism
- vascular injury
- neurological deficit, e.g. sciatic nerve palsy, femoral nerve palsy (rare) ^10,11
- death

A standardized list of complications post total hip arthroplasty was developed by consensus by The Hip Society. This enables consistent standardized reporting of complications ⁸.

Quiz questions

References

1. Taljanovic M, Jones M, Hunter T et al. Joint Arthroplasties and Prostheses. Radiographics. 2003;23(5):1295-314. doi:10.1148/rg.235035059 - Pubmed
2. Keogh C, Munk P, Gee R, Chan L, Marchinkow L. Imaging of the Painful Hip Arthroplasty. AJR Am J Roentgenol. 2003;180(1):115-20. doi:10.2214/ajr.180.1.1800115 - Pubmed
3. Tigges S, Stiles R, Roberson J. Complications of Hip Arthroplasty Causing Periprosthetic Radiolucency on Plain Radiographs. AJR Am J Roentgenol. 1994;162(6):1387-91. doi:10.2214/ajr.162.6.8192005 - Pubmed
4. Blom A, Rogers M, Taylor A, Pattison G, Whitehouse S, Bannister G. Dislocation Following Total Hip Replacement: The Avon Orthopaedic Centre Experience. Ann R Coll Surg Engl. 2008;90(8):658-62. doi:10.1308/003588408X318156 - Pubmed
5. Verberne S, Raijmakers P, Temmerman O. The Accuracy of Imaging Techniques in the Assessment of Periprosthetic Hip Infection: A Systematic Review and Meta-Analysis. J Bone Joint Surg Am. 2016;98(19):1638-45. doi:10.2106/JBJS.15.00898 - Pubmed
6. Verberne S & Temmerman O. Imaging of Prosthetic Joint Infections. Management of Periprosthetic Joint Infections (PJIs). 2017;:259-85. doi:10.1016/b978-0-08-100205-6.00012-4
7. Vanrusselt J, Vansevenant M, Vanderschueren G, Vanhoenacker F. Postoperative Radiograph of the Hip Arthroplasty: What the Radiologist Should Know. Insights Imaging. 2015;6(6):591-600. doi:10.1007/s13244-015-0438-5 - Pubmed
8. Healy W, Iorio R, Clair A, Pellegrini V, Della Valle C, Berend K. Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society. Clin Orthop Relat Res. 2016;474(2):357-64. doi:10.1007/s11999-015-4341-7 - Pubmed
9. Long S, Surrey D, Nazarian L. Common Sonographic Findings in the Painful Hip After Hip Arthroplasty. J Ultrasound Med. 2012;31(2):301-12. doi:10.7863/jum.2012.31.2.301 - Pubmed
10. Schmalzried T, Noordin S, Amstutz H. Update on Nerve Palsy Associated with Total Hip Replacement. Clin Orthop Relat Res. 1997;(344):188-206. - Pubmed
11. AlGhufaily A, Alshunaifi A, AlHarbi J. Femoral Nerve Palsy Post Total Hip Arthroplasty (THA) via a Posterolateral Approach. Cureus. 2023;15(12):e50771. doi:10.7759/cureus.50771 - Pubmed

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