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Materials
Fixation
Prosthesis Types
Total Hip
Hemi
Revision
Radiography
Baseline Exam
Alignment
-Acetab. Position
-Inclination
-Anteversion
-Center of Rotation
-Femoral Stem
-Leg Length Discr.
Intra-op- Fractures
Cement Herniation
Follow-up Study
Bony Abnormalities
Fracture
Heterotopic Bone
Non Union
Hardware Failure
-Polyethylene Wear
-Dislocation
Osteolysis
Loosening
Infection
Arthrography
CT and MRI
References

Intraoperative Fractures

Incidence
- Cemented prostheses 0.4%
- Press-fit prostheses 2.5%
- Revision hip arthroplasty 7.2%
Location
- Pelvis
  - rare
- Femoral shaft
  - Most common
  - Usually at tip of stem in vertical configuration
  - Rarely displaced
  - Occur as the long femoral component stem is pounded into position
  - Usually does not effect outcome.
  - May require cerclage cables
DDx:
- Nutrient foramen in posterior femoral shaft. Always compare with preoperative radiographs
- Control perforation placed by surgeon during revision surgery to aid in removal of previously placed femoral component
Tx
- Usually managed with cautious weight bearing

Intraoperative fracture of the proximal femur.

Intraoperative fracture of the femur at the tip of the femoral stem.

Femoral shaft fracture fixed with cerclage cables.

MEDIAL ACETABULAR FRACTURE

Control perforation lateral femoral cortex, reduced by cerclage cables. A control perforation of the lateral femoral cortex was performed in this revision total hip replacement to facilitate removal of the old femoral prosthesis. It is reduced by cerclage cables.

Vascular channel. Linear lucency seen on pre and post operative frog views is vascular channel. These are seen best on the frog leg view, entering the femoral cortex distally and traveling proximally toward the hip into the marrow space.