Presentation
Bilateral total hip arthroplasty more than 10 years earlier. Worsening right-sided hip pain. Eccentric position of prosthesis head within the cup on radiographs.
Patient Data
The scout image already reveals the cause. The right prosthesis head is in an eccentric position, being in direct metal-on-metal contact with the lateral-cranial aspect of the cup. Appropriate position on the contralateral side.
Also: normal stress-shielding in the greater trochanter on both sides, bilateral sacroilical arthrosis and right-sided partial ankylosis,
Case Discussion
Polyethylene wear is relatively common long-term complication of total hip arthroplasty. Gradual off-center migration of the prosthesis head is usually the first clue. It is important to also compare the position of the prosthesis to the initial postoperative radiographs during follow-up, as between two subsequent radiographs the change might be too subtle to detect.
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