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 continued

Dislocated total hip arthroplasty Left hip unipolar prosthesis (hemiarthroplasty) dislocation Bilateral total hip arthroplasty; right hip arthroplasty dislocation Metal-on-metal left hip arthroplasty with Metallosis and bony erosions
Dislocated hip arthroplasty Left hip unipolar prosthesis dislocation Bilateral hip arthroplasty; right hip arthroplasty dislocation Left hip metal-on-metal prosthesis with metallosis

Most hip arthroplasty dislocations are posterior. From Benjamin, 1994

  Elderly woman with bilateral press fit total hip arthroplasties. There is a dislocation on the right. 68 year-old woman with left hip metal-on-metal prosthesis. Bony erosions (arrows) are evident on the greater and lesser trochanter from probable metallosis with pseudotumor formation.
Right hip dislocation with displaced polyethylene liner  
Right hip dislocation with dislocated liner Right hip dislocation with liner displacement Right hip dislocation with liner displacement  
Initial AP radiograph (left) shows a right hip dislocation. Note the polyethylene liner (arrow) is still associated with dislocated femoral head. The hip was subsequently relocated. The AP radiograph (middle) show subtle eccentric positioning of the reduced femoral head within the acetabular cup. A subtle density (arrows) represents the liner which is now disassociated from the femoral head. This is somewhat more clearly shown (arrow) on the frog leg lateral view (right).  
Metal-on-metal right Hip arthroplasty with heterotrophic bone formation Right Hip Arthroplasty with heterotrophic bone formation Bony osteolysis Subtle failure of total knee arthroplasty (TKA)
Right hip metal-on-metal hip prosthesis Right hip prosthesis with heterotopic bone formation Femoral head resurfacing with osteolysis Left TKA failure
55 year-old man with right hip metal-on-metal arthroplasty and heterotrophic bone formation above the greater trochanter. The metal-on-metal prosthesis was removed and replaced with a standard hip prosthesis due to continued hip pain and chronic fluid collection around the greater trochanter. A later scout CT image shows increased heterotrophic bone formation (arrow) near the revision prosthesis. The heterotrophic bone was later removed. A resurfacing hip arthroplasty is present. The polyethylene acetabular component is radiolucent. Non-infectious osteolysis (arrow) is present at the tip of the femoral stem. From Benjamin, 1994 A noncemented total knee arthroplasty is present with a metal backed patellar component. There is also a polyethylene locking clip which locks the tibial polyethylene into the tibial base plate. The anterior cortex of the femur is notched and eroded (top arrow). There is also subtle subsidence of the tibial component (bottom arrow). From Benjamin, 1994
Aseptic loosening of bilateral total knee arthroplasties
Left TKA after surgery Left TKA 6.5 years after surgery Left knee TKA postoperative radiograph Left knee TKA 6.5 years postoperative
65 year-old woman with bilateral cruciate-retaining total knee arthroplasties (TKAs) placed in early 2009. In November 2015 routine follow-up showed bilateral aseptic loosening in both tibial components with wide periprosthetic lucencies (arrows) and varus deformity on the left. From left to right, respectively, AP radiograph of the left knee in the postoperative period, AP radiograph of the left knee 6.5 years later, lateral radiograph of the left knee in the postoperative period, and lateral radiograph of the left knee 6.5 years later. Images courtesy Laura H Lee, MD.
Aseptic loosening of bilateral total knee arthroplasties continued
Right TKA in postoperative period Right TKA 6.5 years after surgery Bilateral loosening of TKA,s  
65 year-old woman with bilateral cruciate-retaining total knee arthroplasties (TKAs) placed in early 2009. In November 2015 routine follow-up showed bilateral aseptic loosening in both tibial components with wide periprosthetic lucencies (arrows) and varus deformity on the left. From left to right, respectively, AP radiograph of the right knee in the immediate postoperative period, AP radiograph of the right knee 6.5 years later, and standing frontal view of the knees 6.5 years after surgery. Images courtesy Laura H Lee, MD.
Rotating-hinge knee implant Rotating hinge knee implant failure
Right knee revision arthroplasty Right knee revision implant Right knee revision implant failure Right knee revision implant failure
69 year-old man with revision of an infected right knee prosthesis (two left panels). A rotating hinge knee implant was placed. Note the antibiotic beads about the medial aspect of the implant. The two fixation screws and wire are from prior surgery. There was implant failure with disruption of the implant six weeks later (two right panels).
Infected total elbow arthroplasty with eventual placement of a revision total elbow arthroplasty
Infected left elbow prosthesis Infected left elbow prosthesis Revision total elbow arthroplasty Revision total elbow arthroplasty
66 year old man with infected left elbow arthroplasty. The arrows point to areas of periprosthetic lucency suggesting loosening which was found to result from an infected prosthesis. The patient had the prosthesis removed and underwent multiple subsequent surgeries with placement of a revision elbow arthroplasty.


Back to Top

 

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