Hongxia Zhu,1 Lei Fu,2 Yu Xie,2 Xiao Yuan,2 Shengtao Chen,2 Lunli Xie2 

1Department of Traumatic Orthopedics, Hunan University of Medicine General Hospital, Huaihua, Hunan Province, 418000, People’s Republic of China; 2Department of Joint and Hand Orthopedics, Hunan University of Medicine General Hospital, Huaihua, Hunan Province, 418000, People’s Republic of China

Correspondence: Lunli Xie, Department of Joint and Hand Orthopedics, Hunan University of Medicine General Hospital, No. 144 Jinxi South Road, Huaihua, Hunan Province, 418000, People’s Republic of China, Email xielunli@163.com

Purpose: Aseptic loosening (AL) of prostheses is a complex and multi-factorial consequences characterized by nonspecific hip start-up pain, impaired gait, or ambulation. The AL of acetabular components associated with femur prostheses can lead to challenges in accurate diagnosis and suitable therapy, potentially resulting in disaster consequence. This study reported revision of in four cases with AL of acetabular components associated with or without femur prostheses after underwent primary total hip arthroplasty.
Case Description: We present four cases with aseptic loosening of prostheses with a medical history of total hip arthroplasty who presented obvious clinical features of recurrent hip pain or “start-up” pain, limping gait, and worsening of walking. Basing on preoperative imaging materials, and ruling out prosthetic joint infection, the comprehensive analysis revealed migration and radiolucency line around margin of prosthesis, confirming the diagnosis of prosthetic AL. All patients accepted individual revision surgery and acquired satisfactory results basing on the month telephone follow-up duration.
Conclusion: Our case report suggests long femur stem associated with wires cerclage fixation combined with or without bone graft revision for treatment of aseptic loosening of the acetabular components coupled with femur prostheses is a viable technique for achieving reliable fracture healing and satisfactory clinical results. Besides, it is the critical need for individualized approaches to therapeutic method, uniquely intended to address the complexity of this AL after THA.

Keywords: aseptic loosening, total hip arthroplasty, revision surgery, radiolucency line, periprosthetic fracture