Medical Apparatus: Imaging Guide to Orthopedic Devices
HOME | ABOUT | CONTACT US

Gallery of Orthopedic Medical Devices

Introduction

Neck & Spine Gallery

Fracture Fixation Gallery

Joint Arthroplasty Gallery 

 

Complications of Orthopedic Apparatus 

Gallery References

 

 

Gallery of Orthopedic Medical Devices - Complications


By Tim B. Hunter, MD and Mihra S. Taljanovic, MD, PhD

 

Complications of joint arthroplasty

Right shoulder hemiarthroplasty anterior dislocation Right shoulder prosthesis periprosthetic fracture Left elbow semiconstrained prosthesis with olecranon periprosthetic fracture
Right shoulder hemiarthroplasty anterior dislocaton Right shoulder hemiarthroplasty anterior dislocation Right shoulder periprosthetic fracture Left elbow prosthesis with olecranon periprosthetic fracture
    51 year-old woman. From Benjamin, 1994  
Posterior dislocation of a reverse total shoulder arthroplasty Disrupted wrist prosthesis Second generation total wrist arthroplasty and Silastic metacarpophalangeal (MCP) implants.
Reverse total shoulder arthroplasty posterior dislocation Reverse total shoulder arthroplasty posterior dislocation Disrupted Silastic wrist prosthesis Second generation total wrist arthroplasty
    Elderly woman with advanced rheumatoid arthritis. Swanson silicone joint prostheses are present at the right 1st, 2nd, and 3rd metacarpophalangeal joints, and Herbert-like screws are at the proximal interphalangeal joints of the right 2nd, 3rd, and 4th fingers. The Swanson silicone prosthesis at the wrist radiocarpal joint has become completely disrupted with displacement of the radial component. The wrist is misaligned in ulnar deviation. There is extensive remodeling in the long (3rd) finger metacarpal. Metal grommets with Silastic implants are at the thumb and long finger MCP joints. From Hunter, 1994.
Right bipolar radial head prosthesis with eventual prosthesis loosening
Right radial head prosthesis Right radial head prosthesis Right radial head prosthesis loosening Right radial head prosthesis loosening
57 year-old woman with radial head prosthesis and capitellar suture anchor. In 2011 she had a right elbow dislocation with a comminuted radial head fracture. A bipolar radial head prosthesis was placed to treat post-traumatic arthritis. Initial radiographs obtained in 2014 (left two images) showed the prosthesis to be well seated. Later radiographs in 2015 show prominent periprosthetic lucency around the prosthetic stem indicating non-infectious aseptic loosening. There are also chronic fractures of the proximal portions of the right radius and ulna.
Third generation "biaxial" total wrist prosthesis Multiple failed metacarpophalangeal Swanson silicone arthroplasties
Third generation total wrist arthroplasty Left wrist arthrodesis Failed MCP arthroplasties Failed MCP joint arthroplasties
52 year-old woman with rheumatoid arthritis and left total wrist prosthesis which failed three years later and was replaced by a wrist arthrodesis. The distal stem of the prosthesis protruded out of the left 3rd metacarpal. The radiograph of the left wrist arthrodesis shows 2nd-5th MCP Swanson silicone arthroplasties, most of which are at least partially displaced. On the patient's right side there are also extensive changes of rheumatoid arthritis with multiple failed Swanson silicone MCP prostheses (see the two images to the right). 52 year-old woman with severe rheumatoid arthritis in the right hand and wrist. There are multiple failed MCP Swanson silicone prostheses with partial displacement and bone fracturing. There is surgical arthrodesis at the right index finger MCP joint and bony fusion from long standing arthritis in the wrist and thumb MCP joint. In her left hand and wrist there was failure of a wrist prosthesis and failure of MCP joint arthroplasties (see the two images to the left).
Osteolysis and particle disease in right hip replacement Osteolysis and particle disease in right hip implant
 
Osteolysis and hip particle disease Osteolysis and particle disease in hip replacement Osteolysis and particle disease in right hiip implant Right hip osteolysis and particle disease with displaced acetabular implant component
 
 
There is displacement of the right acetabular implant component and osteolysis from granulomatous particle disease. A left metal upon metal hip implant is present.

Back to Top

 

Left hip arthroplasty: polyethylene liner wear with associated osteolysis and particle disease
Left hip arthroplasty: polyethylene liner wear with associated osteolysis and particle disease Left hip arthroplasty: polyethylene liner wear with associated osteolysis and particle disease Left hip arthroplasty: polyethylene liner wear with associated osteolysis and particle disease - axial CT image Left hip arthroplasty: polyethylene liner wear with associated osteolysis and particle disease - coronal CT iamge
 
 
Axial CT image Coronal CT image
Particle disease (arrows) left hip coronal CT image Focal osteolysis about femoral stem of total hip arthroplasty Femoral osteolysis and loosening of noncemented total hip arthroplasty Right ankle prosthesis failure with loosening of components and polyethylene wear medially
Left hip particle disease CT coronal image Femoral osteolysis in zones 2, 5, and 7 Total femoral osteolysis Right ankle prosthesis failure
68 year-old man with particle disease from a worn out left hip prosthesis. Bony destruction (arrows) is in the left supra-acetabular region and in the left greater trochanter with a pathologic fracture. Cemented total hip arthroplasty with focal osteolysis about the stem in zones, 2, 5, and 7. From Hunter, 1994. There is radiolucency (arrow) around the entire femoral stem with a sclerotic margin. There is also thinning of the lateral femoral cortex. From Hunter, 1994. 68 year-old woman with total ankle prosthesis failure with loosening of tibial and talar component shown by bony lucency about the components and medial polyethylene liner wearing.
Right hip arthroplasty polyethylene wear Left total knee prosthesis patellar button dislocation Right total knee prosthesis patellar button dislocation
Right hip polyethylene wear Left total knee prosthesis patellar button dislocation Right total knee prosthesis patellar button dislocation Right total knee prosthesis patellar button dislocation
 
The patellar button is dislocated superiorly (arrow). The patellar component (button) is dislocated inferiorly (arrow)
Displaced polyethylene liner in right hip arthroplasty Semiconstrained left elbow arthroplasty with heterotopic bone formation  
Displaced polyethylene liner Elbow prosthesis and heterotopic bone Elbow prosthesis and heterotopic bone  
Image courtesy Lana Hirai Gimber, MD 35 year-old woman with prior gunshot injury to left upper extremity. Multiple surgeries were performed to remove wooden fragments and shrapnel. Extensive heterotopic bone has developed about the left humerus and left elbow arthroplasty. Portions of previous fixation screws and plates are evident.  
Disrupted left total knee prosthesis Failed constrained total knee arthroplasty from destructive particle disease
Disrupted left total knee prosthesis frontal view Disrupted left total knee prosthesis lateral view Particle disease in constrained TKA Particle disease in constrained TKS
    96 year-old woman with destructive particle disease causing large areas of bone destruction (arrows).
Right femur supracondylar periprosthetic fracture
Right femur TKA periprosthetic fracture Right femur TKA periprostheticfracture Right femur periarticular plate Right femur periarticular plate
74 year-old women who was in an automobile accident and suffered a right femur supracondylar periprosthetic fracture about her cruciate retaining TKA. The fracture was treated with a lateral periarticular plate and screws.

Back to Top

 

Joint arthroplasty complications continued...

Complications of neck and spine apparatus

Complications of fracture fixation

 


Author contact information

Tim Hunter
Email: hunter@radiology.arizona.edu


COPYRIGHT 2013: TBH
All Rights Reserved

Publisher Contact Information

Main office: USA (New York)
Cambridge University Press
32 Avenue of the Americas
New York, NY 10013-2473

Phone: (212) 337-5000
Email: newyork@cambridge.org