الفهرس 
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Abstract
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SUMMARY AND CONCLUSION
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Total hip replacement brought dramatic relief of
pain, as well as marked improvement in the quality
of life to many patients. But, it is due to the
increased incidence of •••• t10 loosening that part
of its limitation became obvious.
A study of twenty cases that needed revision
surgery for asceptic loosening showed that radiolucent
lines were important findings in the diagnosis
of the condition.
On the acetabular side, the classification of
Charnley and De Lee of the three acetabular zones
was found to be significant. The presence of a
radiolucent line more than 2mm in width,in zone 3
was diagnostic of loosening of the acetabular
component.
On the femoral side, the presence of radiolucent
lines were very significant, sp~cially where there
is increase in extent and width of these line.
The presence of a good cement mantle was found
to be an important factor in medbtaning stability.
where the cement mantle was incomplete or inadequate
it.has led to increase stresses and subsequent
loosening. Incomplete cement mantle was found to
be present on 60% of cases in this study.
Improper positioning of prosthesis was a
contributing factor to loosening. It was found
that the femoral stem was in varus position in 25%
75
of the cases.
Shock loads, in the form of repeated minor
traumata, proved to increase stresses and has led
to loosening of prosthesis in IQ% of cases.
Basically, loosening is a stress related
phenomena. In order to make the implant ation of
prosthesis more durable attempts should be made for
improving the fixation and reducing the stresses
applied to it. In the present state of knowledge in
this field, it seems probable that improvements and
refinements in cementing technique and surgical techn
ique as suggested, will lead to a better fixation
and therefore, reduction in the incidence of loosening.
Despite all technical efforts that have been
suggested, it seems likely that the problem cannot
be totally resolved without the patients’ major
contribution in reduction of stresses that is to
control the level of physical actiVities, 8S well 8S
their body weights.