Revision Surgery for Aseptic Loosening of Total Hip Replacement — Acetabular Reconstruction

Abstract

To consider further surgery upon a total hip arthroplasty implies that the first procedure has ended in failure. This failure is due to movement of the components relative to the bone to which they may or may not have been cemented. In the absence of infection, failure occurs for two main reasons: poor operative technique or an unsatisfactory prosthesis which has high built-in friction or whose components are poorly adapted to the bone. Failure is also often blamed on the cement or on poor bony ingrowth into the irregularities on the surface of the prosthesis. These factors are often necessarily related: they lead to functional failure as a result of movement of the components and this causes bony damage to a varying degree. To reoperate implies that one has the intention and ability to do better than on the first occasion, that one has understood the reason for the failure, and that one has the means to improve on it.