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Loose right total hip replacement with heterotopic ossification of left total hip replacement

Case contributed by Jack Ren
Diagnosis certain

Presentation

Pain right hip some years post THR

Patient Data

Age: 75
Gender: Male

There are bilateral total hip arthroplasties in situ, cemented on the right, uncemented on the left.

Right side:  The femoral head is asymmetrical in the acetabular cup indicating loss of polyethylene liner laterally and superiorly. There is lucency at the bone cement interface along the lateral margin of the right femoral prosthesis. Lucency is seen at the cement prosthesis interface along the distal femoral component. Heterotopic ossification is seen arising mainly from the lateral acetabulum with >1 cm between opposing surfaces of bone.

Left side: Heterotopic bone extends from the acetabulum across to the greater trochanter, giving the appearance of ankylosis. 

 

Case Discussion

In this case the patient had a painful right hip, the hip prosthesis was considered loose and was revised. He was likely to limited hip movement on the left secondary to the heterotopic ossification.

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