Revision arthroplasty: placement of new component(s) following removal of failed prosthesis/component
Wide spectrum of revision
Small changes may not be obvious
Exchange of polyethylene component
Change of femoral head (modular; may be changed without extracting stem)
Larger changes of entire components
Some revisions have implications related to substantial bone loss: large defects to fill, little bone to support implant
Loose components may fracture and erode large regions of bone
Infection may destroy bone
Small particle disease with massive osteolysis leaves bone defects
Imaging evaluation required both pre- and postoperatively
Preoperative: evaluation of bone stock for surgical planning
Postoperative: evaluation for complications
Arthroplasty = name for procedure (surgery), not for device (prosthesis/implant)
IMAGING
Radiographic Findings
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Selected References
Sculco PK et al: The diagnosis and treatment of acetabular bone loss in revision hip arthroplasty: an international consensus symposium. HSS J. 18(1):8-41, 2022
Rath B et al: [Revision total hip arthroplasty: significance of instability, impingement, offset and gluteal insufficiency.] Orthopade. 48(4):315-21, 2019
Schmolders J et al: Validation of the Charlson comorbidity index in patients undergoing revision total hip arthroplasty. Int Orthop. 39(9):1771-7, 2015
Eswaramoorthy VK et al: Clinical and radiological outcome of stemmed hip replacement after revision from metal-on-metal resurfacing. J Bone Joint Surg Br. 91(11):1454-8, 2009
Symeonides PP et al: The effectiveness of the Burch-Schneider antiprotrusio cage for acetabular bone deficiency: five to twenty-one years' follow-up. J Arthroplasty. 24(2):168-74, 2009
Williams D et al: Revision arthroplasty: an update. Skeletal Radiol. 38(11):1031-6, 2009
Choplin RH et al: Total hip arthroplasty in patients with bone deficiency of the acetabulum. Radiographics. 28(3):771-86, 2008
Ogawa H et al: Morcellized bone grafting for acetabular deficiency in cementless total hip arthroplasty. Orthopedics. 31(10), 2008
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Diagnostic Checklist
TERMINOLOGY
Definitions
Revision arthroplasty: placement of new component(s) following removal of failed prosthesis/component
Wide spectrum of revision
Small changes may not be obvious
Exchange of polyethylene component
Change of femoral head (modular; may be changed without extracting stem)
Larger changes of entire components
Some revisions have implications related to substantial bone loss: large defects to fill, little bone to support implant
Loose components may fracture and erode large regions of bone
Infection may destroy bone
Small particle disease with massive osteolysis leaves bone defects
Imaging evaluation required both pre- and postoperatively
Preoperative: evaluation of bone stock for surgical planning
Postoperative: evaluation for complications
Arthroplasty = name for procedure (surgery), not for device (prosthesis/implant)
IMAGING
Radiographic Findings
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Selected References
Sculco PK et al: The diagnosis and treatment of acetabular bone loss in revision hip arthroplasty: an international consensus symposium. HSS J. 18(1):8-41, 2022
Rath B et al: [Revision total hip arthroplasty: significance of instability, impingement, offset and gluteal insufficiency.] Orthopade. 48(4):315-21, 2019
Schmolders J et al: Validation of the Charlson comorbidity index in patients undergoing revision total hip arthroplasty. Int Orthop. 39(9):1771-7, 2015
Eswaramoorthy VK et al: Clinical and radiological outcome of stemmed hip replacement after revision from metal-on-metal resurfacing. J Bone Joint Surg Br. 91(11):1454-8, 2009
Symeonides PP et al: The effectiveness of the Burch-Schneider antiprotrusio cage for acetabular bone deficiency: five to twenty-one years' follow-up. J Arthroplasty. 24(2):168-74, 2009
Williams D et al: Revision arthroplasty: an update. Skeletal Radiol. 38(11):1031-6, 2009
Choplin RH et al: Total hip arthroplasty in patients with bone deficiency of the acetabulum. Radiographics. 28(3):771-86, 2008
Ogawa H et al: Morcellized bone grafting for acetabular deficiency in cementless total hip arthroplasty. Orthopedics. 31(10), 2008
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