- Discussion:
- common reasons for revision include
sepsis,
component malposition, impingement, polyethylene wear,
pelvic osteolysis,
recurrent dislocation, progressive protrusio, and
component loosening;
- most common indication for revision THR is loosening of the prosthesis with subsequent pain and varying degrees of bone loss;
- these are major procedures, and pain is usually so great that hip function is significantly limited;
- radiologic signs of loosening in hips with little pain should be watched carefully, and serial films taken;
- if major bone destruction progresses, even when pain is not too disabling, revision should be done before bone destruction proceeds
to the extent that successful revision is less likely;
- painful loosening is the major indication for revision, although impending frx, component malposition with recurrent dislocation,
or other problems that would make a revision more difficult can be indication;
