Hip Replacement – Bone Loss
One of the challenges in hip replacement is dealing with bone loss. This is usually the case in revision surgery where loosening of the implant leads to large cavities or holes in the bone. This leads to a weak foundation to put in another implant solidly. There are a number of ways to solve this issue. If the bone loss is small, one can simply put in bone cement, and implant into the bone. In this case the bone cement will fill the defect.
However, this is not possible with massive bone loss. . The solution is a combination of using bone graft and implants that cater for the deficiency (metal augments that fill the bone defects).
In the case of the femur (thigh bone), we use longer, bigger implants that cover a much larger surface area of the bone to integrate.
Image showing a loose total hip replacement on the right side. The arrows are pointing to loosening of the implant with massive bone loss.
The new implant has been put in, and large bits of metal substituted for the bone loss; this x-ray is one year after the procedure.