3. Hodgkinson classification of radiographic demarcation of the socket following total hip arthroplasty

#### 3.1. Introduction

This classification was proposed by Hodgkinson et al. from Wrightington, UK in 1988. He reviewed 200 patients undergoing revision arthroplasty and found out strong correlation between the extent of radiographic demarcation at bone-cement interface and intraoperative loosening of cemented acetabular components [4].

reconstruction and thereby assists with ensuring that the appropriate implants and instruments are available at the time of surgery [5]. Gozzard et al. found moderate agreement between the preoperative and intraoperative validity; but the reliability of the classification

Classifications Used in Total Hip Arthroplasty http://dx.doi.org/10.5772/intechopen.77231 23

Type 3A: 2A plus diaphyseal bone loss but at least 4 cm of diaphyseal support possible.

Type 1: Cemented or proximally porous coated cementless implant can be used.

Type 3B: Modular tapered cementless stems are used if adequate bone stock.

should be avoided because of loss of metaphyseal endosteal bone.

Type 3B: 2B plus diaphyseal bone loss with less than 4 cm of diaphyseal support available.

Type 2A, 2B, 2C: Extensively porous coated cementless stem is preferred. Cemented stem

Type 3A: Extensively porous coated stems or modular distal fitting tapered stems can be used.

was found to be fair (Figure 3).

Figure 3. Paprosky classification.

Type 1: Minimal metaphyseal and diaphyseal bone loss.

Type 2C: Posteromedial metaphyseal bone loss.

Type 3C: 2C plus complete diaphyseal bone loss.

Impaction bone grafting is also an option.

Type 2A: Absent calcar extend just below the inter-trochanteric region.

Type 2B: Anterolateral metaphyseal bone loss wit absent calcar.

4.2. Classification

4.3. Clinical applications

#### 3.2. Classification

Type 0: No demarcation.

Type 1: Demarcation of outer one-third.

Type 2: Demarcation of outer and middle thirds.

Type 3: Complete demarcation.

Type 4: Socket migration.

#### 3.3. Clinical significance

This classification helps surgeon help decide between partial or complete revision preoperatively.
