A method was developed for the post-mortem evaluation of a total hip
replacement retrieved in situ. The hip replacement had been implanted for
six years. The evaluation procedure employed existing techniques in a
logical sequence such that earlier tests would not compromise results from
subsequent ones. These techniques included the measurement of range of
motion, aspiration of the joint for analysis of debris, radionuclide
arthrograms for determination of looseness of the components, gross and
histological inspection of the capsule and synovial tissue, serial
sectioning of the femoral component, determination of some mechanical
properties of the bone and femoral stem, and scanning electron microscopy
of the articulating surfaces of the prosthetic components. Positive
findings in the specimen studied were: excessive wear of the articulating
surface of the acetabular component, and associated polyethylene debris in
the aspirate and surrounding synovial and granulation tissue.