Arthroplasty performed for the partial or complete resurfacing, remodelling or replacement of a degenerative or dysfunctional joint is a common procedure. The number of total knee and hip arthroplasty procedures performed per year are increasing with the number of total knee arthroplasties (TKA) predicted to more than double by 2030. Although this provides dramatic relief from pain, these implants do have a limited lifespan.

Approximately 10% of total hip arthroplasty (THA) implants require revision due to periprosthetic osteolysis. Approximately 40% require revision due to aseptic loosening believed to be due to polyethylene wear. Arthroplasty prostheses may also fail due to deep infection, malpositioned or oversized implants and peri-prosthetic fractures. It is difficult to predict which patients will develop complications. Therefore follow up has typically involved serial clinical and radiographic assessments for the lifetime of the patient. Despite many collective years of experience there is still disparity in the follow-up of such patients. Elective arthroplasty forms the major bulk of workload in trauma and orthopaedic surgery. Efficient service provision and planning requires an agreed, evidence-based protocol. Currently no consensus exists, however there are many papers detailing the effectiveness of imaging techniques as well as the need for timed clinical assessments.

The authors review current literature regarding hip and knee arthropalsty procedures, potential causes of failure and methods of detection in order to highlight areas of potential future research to enable an evidence-based protocol to be derived.

Aims

Revision total hip arthroplasty is a common operation. The MP Link (Waldemar Link, Hamburg, Germany) system is a distally loading, modular, tapered femoral stem component for revision hip surgery. MP Link in revision total hip arthoplasty was investigated clinically, radiologically and with Oxford hip scores.