Diagnosis and treatment tactics for aseptic implant loosening and osteomyelitis in hiparthroplasty

On the base of retrospective analysis of 673 hiparthroplasties with Sivash implant clinical and X-ray signs of aseptic prosthesis loosening (early, marked and severe) as well as osteomyelitis are systematized. Possibility of early radiologic osteomyelitis diagnosis is shown. It is noted that periosteal excrescences in aseptic implant loosening developslower and later in compare with osteomyelitic periostitis. The former are characterized by great spreading along diaphysis, have uniform density and clear counter, while periostites have uneven density and fringed counter. Tactics of treatment including the possibility of implant preservation, revision arthroplasty and prosthesis removal with palliative operation is given.