Postoperative Imaging of Hip Arthroplasty

Hip arthroplasty has become the standard treatment for end-stage hip disease. Complications include aseptic loosening, infection, foreign-body granulomatosis (osteolysis), adverse reactions to metal debris, periprosthetic fracture, heterotopic ossification, hardware failure, and a range of soft tissue-related complications, all of which may result in pain; the risk of developing them depends on factors such as the type of prosthesis used, duration after surgery, patient characteristics, and surgical approach. While their overall incidence is low, they are often encountered due to the increasing frequency of procedures performed. Consequently, there is a growing demand for a timely and accurate diagnosis of postoperative complications and strategies for monitoring patients who are at risk. While radiographs are still the first imaging modality for routine follow-up and initial workup of the painful postoperative hip, CT and MRI are currently central for the diagnosis of hip arthroplasty complications due to recent advancements in both modalities. This chapter provides a brief overview of the different types of hip prostheses and discusses normal postoperative appearances and some of the more common complications associated with hip arthroplasty. Relevant imaging findings are illustrated, and the role of various imaging modalities is reviewed.