Fig. 1

X-ray of the right hip joint in two planes: A) mediolateral projection and B) anterior-posterior projection show a decentered prosthesis head as evidence of inlay wear but no evidence of periprosthetic fracture or material loosening. Pronounced, periarticular heterotopic ossification (A) with bridging of the joint space (grade 4 according to Brooker). Flaw changes in the density of the peri-prosthetic region hint toward heavy metal abrasion. Streaky calcifications consistent with myositis ossificans (especially seen in A) in projection to the adductors and rotators indicate local inflammation probably related to metal abrasion. C Explanted femoral head and neck. Note the massive wear of the head, which was round at the time of implantation. D Leakage of black synovial fluid after removal of the hip joint capsule. E Massive metallosis and synovialitis after luxation of the hip joint. Abrasion of the femoral head of the prosthesis