Objective: This article reviews the imaging features of revisions and complications of hip replacement arthroplasty and relates these features to the current understanding about how and why these failures occur.
Conclusion: Short-term failures of hip replacements are most commonly the result of instability and dislocation. Complications ranging from osteolysis caused by granulomatous reaction to particulate wear debris lead to many long-term failures. Attempts to reduce wear debris through changes in design and materials have reduced the rate of some complications but have resulted in new ones. Infection remains a devastating complication that is difficult to resolve.