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. 2011 May;8(2):14-8.

Hip painful prosthesis: surgical view

Antonio Spinarelli  1 , Vittorio Patella, Vito Conserva, Giovanni Vicenti, Vito Pesce, Silvio Patella
Affiliations

Hip painful prosthesis: surgical view

Antonio Spinarelli et al. Clin Cases Miner Bone Metab. 2011 May.

Abstract

Painful hip prosthesis is the most feared immediate and remote complication of a primary implant and usually represents the failure of one or more therapeutic moments. In cases of aseptic implant failure, the causes invoked may be represented by an incorrect indication, the quality of materials, local and general condition of the patient and especially from a bad joint biomechanics. In cases of septic loosening, however, the cause of failure to be found in the location of pathogens within the implant. In planning a revision is necessary to respect many important steps. They are represented by the exact identification of the causes of failure, the correct preoperative planning, by respecting the skin incisions, the proper choice of the prosthesis, planning the surgical technique, and finally by an appropriate rehabilitation program.In the evaluation of hip failure the first diagnostic step is to recognize exactly those aseptic and septic forms anyway to exclude the diagnosis of infection.

Keywords: THA; bone-loss; infection; loosening.

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Figures

Figure 1
Figure 1
Periprosthetic osteolysis of the proximal femur due to poly wear.
Figure 2
Figure 2
Breakage of the stem probably due to fatigue.
Figure 3
Figure 3
Revision with Wagner stem using Wagner osteotomy.
Figure 4
Figure 4
Luxation of the stem due to a massive periacetabular bone-loss subsequent to osteolysis.
See this image and copyright information in PMC

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