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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

Polyethylene Liner Wear

• Liner thinning related to chronic wear
• Occurs in superior aspect, along biomechanical vector of force
• Debris from liner is most common inciter of osteolysis (Schmalzried)
• Radiographic features
• Femoral head component eccentrically located in cup
• Ddx: Polyethylene liner dislocation

Polyethylene liner wear seen or radiograph and CT coronal reconstructed image. Note eccentric position of femoral head in cup

Severe polyethylene liner wear with associated osteolysis of ischium and proximal femur

Polyethylene cup dislocation. AP radiograph demonstrates eccentric positioning of femoral head in cup with subtle curvilinear density inferiorly corresponding to dislocated polyethylene liner. Arthrographic spot film demonstrates contrast outlining the polyethylene liner. Model of total hip replacement components positioned with polyethylene liner dislocated.

Metal liner dislocation. Model of total hip replacement components positioned with metal  liner dislocated.