Plain film and arthrographic findings in painful total hip arthroplasties with surgical correlation

The plain films and arthrograms performed on 42 painful cemented hip arthroplasties in 40 patients were reviewed and the radiological findings compared to the surgical assessment of component stability. All radiography, which included Judet views in the plain films, was reviewed without knowledge of the surgical findings and without comparison with previous studies. Criteria for the detection of loosening of cemented femoral and acetabular components were predetermined. The accuracy of plain film assessment of acetabular component stability was increased significantly (p less than 0.05) by including oblique views in the plain film assessment. The accuracy of assessment of acetabular component stability on plain films was 88%, on arthrography 90% and, with both studies combined, was 98%. Femoral component stability was assessed accurately on 90% of plain films and 90% of arthrograms, and this was not improved by combining the studies. The difficulty of detecting low grade infections is discussed with results of pseudocapsule aspiration.