Arthrography in twenty-five painful hips of twenty-one patients after
total hip replacement and in fifty-three asymptomatic hips of forty-two
patients after this procedure showed that arthrographic evidence of
loosening was not always associated with pain. More than one-fifth of the
asymptomatic hips had arthrographic evidence of loosening. Furthermore, the
loosening shown by arthrogram could be confirmed in only seven of twelve
hips that were subsequently explored. In addition, there was no apparent
relationship between arthrographic loosening and the presence of a
Trendelenburg sign. This study casts doubt on the value of an arthrogram in
the diagnosis of the cause of pain after total hip replacement.