Polyethylene wear (hip arthroplasty)
Bilateral total hip arthroplasty more than 10 years earlier. Worsening right-sided hip pain. Eccentric position of prosthesis head within the cup on radiographs.
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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,
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.