This diagnostic X-ray shows a right total hip arthroplasty (THA) in a four-year follow-up status. The visual content demonstrates an original cementless ABG I prosthesis consisting of a metallic femoral stem and an acetabular cup. The femoral stem is anatomically positioned within the medullary canal of the proximal femur, showing stable osseointegration. A metallic femoral head is articulated with the acetabular cup. Notably, there is evidence of post-surgical changes in the periprosthetic acetabular region where radiodense material indicates the placement of bone graft to address previous osteolysis. The proximal femur shows some signs of bone remodeling, including mild radiolucency in the superior metaphyseal region (Gruen zones 1 and 7), which is suggestive of stress shielding—a common phenomenon where the rigid metal implant alters normal load distribution. The alignment of the implant components appears stable with no signs of hardware loosening, migration, or fracture.

Two intraoperative fluoroscopic (X-ray) views of a total hip arthroplasty (THA) demonstrate final implant placement and orthopedic hardware positioning. The imaging shows a radiodense femoral component consisting of a tapered metallic stem inserted into the medullary canal of the proximal femur and a spherical femoral head. The femoral head is articulating with an acetabular cup, which appears as a faint, radiolucent crescent within the pelvic acetabulum. Anatomical landmarks including the greater trochanter and lesser trochanter are visible, serving as reference points for assessing leg length and offset. The bone-implant interface displays no significant radiolucency, suggesting stable initial fixation. The positioning is consistent with standard surgical parameters for alignment and joint restoration. These images are used in surgical education to illustrate the confirmation of implant seatedness and overall joint reconstruction during the final stages of a direct anterior approach (DAA) hip replacement.

This composite diagnostic image illustrates an orthopedic preoperative planning simulation for a total hip arthroplasty (THA) in a 46-year-old female with Crowe III developmental dysplasia of the hip. The visualization combines multiple modalities: a full-length coronal X-ray of the femur showing the anatomical stem placement (orange), and several axial CT scan slices providing cross-sectional views of the femoral canal and pelvis. A 3D anatomical model of the prosthesis, including a turquoise acetabular cup and an orange femoral stem with a spherical head, is superimposed on the radiographic data. Key features shown include the native femoral anteversion (60°) and the simulated cup anteversion (16°). The layout demonstrates the spatial relationship and fit of the implant at various anatomical levels. The simulation evaluates parameters such as combined anteversion, offset restoration, and canal filling. In this specific case, the reconstruction is categorized as unacceptable because the combined anteversion exceeds the clinical limits established by Dorr and Widmer, highlighting the challenges of anatomical stem designs in patients with severe femoral dysplasia.

This axial X-ray of the right hip demonstrates a postoperative view of a periprosthetic femoral fracture managed with internal fixation. A primary total hip arthroplasty (THA) is visible, featuring a femoral stem and a prosthetic femoral head articulating within the acetabulum. The fracture site, primarily involving the proximal femur/greater trochanter region, is stabilized with a long lateral locking plate and screw construct extending distally along the femoral shaft. Multiple cerclage wires encircle the proximal femur to provide additional circumferential compression and stability for the fracture fragments around the pre-existing prosthesis. The imaging shows successful anatomical alignment of the bone and hardware placement, which is characteristic of the management of Vancouver B1 or C type periprosthetic fractures where the primary stem remains stable. This clinical image is educational for understanding orthopedic revision strategies and the integration of osteosynthesis hardware with existing arthroplasty components.