Loosening of the hip joint prostheses.

The most common situations that lead to the need for a revision hip replacement are instability / dislocation, mechanical loosening and infection. According to one national review study, instability issues account for 22% of all revision hip replacements, aseptic loosening for 20% and infection the cause of 15% of yearly revision hip replacement surgeries [3]. Periprosthetic fracture, component failure and osteolysis-related wear are the causes for the remaining revision hip replacements done each year. Of great concern looking forward is that infection by the year 2030 will account for 48% of all revision hip replacements that will be done [4]. This has grave economic implications as infection is one of the most expensive complicating events related to joint replacement surgery.

Resources on Aseptic Loosening of Total Hip Replacement from JAAOS.

Implant Loosening Following Hip Replacement Surgery

Compare Hip Prosthesis And Loosening Of Screw …

Based on the results obtained in histological examinations carried out on periprosthetic tissues in a large series of cases of prosthetic hip joint explants, the authors analyze the cellular events that may occur in loosening phenomena as compared to what occurs in the paraphysiological repair process that is observed in the stable prosthesis. Like other authors, they believe that the principal role in the mechanism of loosening is played by macrophages which are recalled in a large number, at times together with multinucleate giant cells, at the bone-implant interface, after micromovements of the prosthesis and the formation of wear particles have occurred. The macrophages would be capable of favoring resorption of the periprosthetic bone tissue, producing areas of osteolysis in which the transmission of the mechanical stress of loading is modified. The ensuing prosthetic instability increases wear phenomena, causes a greater amount of osteolysis, and, in a vicious cycle, loss of the relationship between bone and implant, and, thus, prosthetic loosening. Finally, the authors report a hypothesis on the pathogenesis of the phenomenon, based on which non-physiological stress, associated with wear and eventually infection, leads to loosening.

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The major causes of failure in hip replacement are: dislocation of the joint, loosening of the stem and cup, and failure of the stem. Dislocation of the prosthesis can occur immediately after surgery if you move your leg into a prohibited position. It is therefore necessary to avoid extremes of , , and for about 12 weeks until a thick capsule forms around the artificial joint. If you dislocate, you will need to be put under deep anaesthesia so your hip muscles can relax sufficiently to allow the artificial hip joint to be reduced. Care should be taken to avoid dislocation as the sciatic nerve, which supplies large leg muscles, is in danger of damage when your hip dislocates.

Revision surgery, to correct a loose implant, is generally more difficult and takes longer to perform than the initial hip replacement.
Learn Loosening Hip Prosthesis Kneel Hip Flexor …

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The prevailing principal in dealing with any fracture around the hip is to gain stability of the fracture and then gain stability of the hip replacement. Both the bone and the prosthesis must be stable to allow any weight bearing. It is rare that full weight bearing is allowed before the fracture is healed. In addition, if the prosthesis comes loose from the fractured bone the surgeon will typically try to bypass the fractured area of the bone to obtain firm fixation on bone further down the shaft. On very rare occasions it may be necessary to replace most of the shattered femur with a very large hip replacement prosthesis referred to as an oncologic prosthesis, one that is used in cases where a tumor has destroyed the bone.

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The Hip Prosthesis Loosening Bone Scan Hip Tendon …

Lucent lines don't necessarily represent problem - may be present in well-fixed prosthesis (retrieval studies) - often due to remodelling O'Neil & Harris JBJS Am'84 1. Possible Bone-cement lucency - may be due to poor cementing technique - loosening if progressive 2. Probable Cement-implant radiolucent line >2mm wide - progressive 3. Definite 1.

The Mechanical Loosening Of Hip Prosthesis How Long …

Loosening of the cemented hip prosthesis

Loosening tends to be more frequent in younger and more active patients and in those who have undergone previous hip surgery. A diagnosis of loosening is based on the patient's symptoms, radiographic changes and other tests, such as bone scans or an arthrogram.