ABSTRACT
Although total hip arthroplasty (THA) is one of the most innovati ve and successful procedures in modern medicine, the number of patients who need a revision is rapidly increasing. In the long-term, the main reason for fai lure of all types of total hip implants is aseptic loosening. Aseptic loosening is influenced by a number of factors but will result in osteolysis around the failed implant. In most patients osteolysis is associated with progressive pain, especially when the implant is unstable. However, in some cases there is radiological evidence of progressive osteolysis in patients who are symptom-free. Revision hip replacement when there is extensive bone loss is more demanding, and the greater the bone loss, the less successful is the outcome. Therefore, regular follow-up radiographs, especially in patients at high risk of revision, is mandatory after hip replacement. The most frequent indication for revision of a failed hip arthroplasty is pain, progressive loss of function, increasing physical disability, and in some cases progressive osteolysis on radiographs. During revision surgery, removal of prostheses frequently causes additional loss of bone stock. The loss of bone stock around the prosthesis is therefore the key problem to be addressed in revision surgery.
