Polyethylene wear (hip arthroplasty)

Case contributed by Dr Balint Botz

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

Age: 60 years
Gender: Male

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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Case information

rID: 79690
Published: 2nd Jul 2020
Last edited: 4th Jul 2020
Inclusion in quiz mode: Included
Institution: University of Pécs

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