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Theofilos Karachalios School of Health Sciences, Faculty of Medicine, University of Thessalia, University General Hospital of Larissa, Mezourlo Region, 41110 Larissa, Greece

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George Komnos Orthopaedic Department, University General Hospital of Larissa, Greece

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Antonios Koutalos Orthopaedic Department, University General Hospital of Larissa, Greece

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and cross-sectional modern imaging (MRI) have proven useful in the diagnostics of ARMD in patients with unexplained hip pain. However, systematic screening for ARMD has been challenged due to methodological reasons. 23 - 27 Periprosthetic

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J R W Crutsen Department of Orthopaedic Surgery, VieCuri Medical Center, Venlo, the Netherlands

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M C Koper Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Zoetermeer, the Netherlands

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J Jelsma Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands

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M Heymans Zuyderland Academy, Centre of Knowledge and Information (KIC), Zuyderland Medical Centre, Sittard-Geleen, the Netherlands

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I C Heyligers Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands
School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands

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B Grimm Luxembourg Institute Health, Human Motion, Orthopaedics, Sports Medicine, Digital Methods (HOSD), Luxembourg, Luxembourg

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N M C Mathijssen Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Zoetermeer, the Netherlands

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M G M Schotanus Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen-Heerlen, the Netherlands
School of Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands

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(e.g. tinnitus, vertigo, deafness, blindness, convulsions, headaches and peripheral neuropathy), cardiotoxicity and thyroid toxicity ( 14 ). Nausea, anorexia and unexplained weight loss have also been described ( 6 , 15 , 16 , 17 ). Initially

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Stein J. Janssen Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands

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Iris van Oost Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Breda, The Netherlands

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Stefan J.M. Breugem Department of Orthopaedic Surgery, Bergman Clinics, Naarden, The Netherlands

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Rutger C.I. van Geenen Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care Education), Amphia Hospital, Breda, The Netherlands

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a titanium TKA four years after UKA. 110 Despite the numerous pathophysiological explanations for symptoms after UKA, there remains a subgroup of patients with unexplained pain. This vexing problem does not justify revision as studies demonstrate

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, La Paz University Hospital - IdiPaz, Spain

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Primitivo Gómez-Cardero Department of Orthopaedic Surgery, La Paz University Hospital - IdiPaz, Spain

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infection, one case of arthrofibrosis, and two cases of failure due to unexplained pain. The most common complication after UKA was mobile-bearing dislocation in the mobile-bearing knees and loosening of the prosthesis in the fixed-bearing knees, but

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Christoph H. Lohmann Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Sanjiv Rampal Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Martin Lohrengel Department of Orthopeadic Surgery, Otto-von-Guericke University, Leipziger Str. 44,39120 Magdeburg, Germany

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Gurpal Singh Division of Musculoskeletal Oncology, University Orthopaedics Hand and Reconstructive Microsurgery Cluster, National University Health System, 1E Kent Ridge Road, 119228 Singapore

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unexplained pain, assessed by two observers who were blind for clinical data. 31 Hybrid SPECT/CT of THA has recently been shown to be reliable in excluding aseptic loosening as well as being beneficial with reference to the extent and maturity of

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E. Mascard Necker University Hospital, 75015 Paris, France.

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N. Gaspar Department of Pediatrics, Institute Gustave Roussy, 94805 Villejuif, France

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L. Brugières Department of Pediatrics, Institute Gustave Roussy, 94805 Villejuif, France

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C. Glorion Orthopedic Surgery Department, Necker University Hospital, 149 rue de Sèvres, 75015 Paris, France

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S. Pannier Orthopedic Surgery Department, Necker University Hospital, 149 rue de Sèvres, 75015 Paris, France

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A. Gomez-Brouchet Laboratoire d'anatomie et cytologie pathologiques, Institut Universitaire du Cancer de Toulouse- Oncopole, 1 avenue Irène Joliot-Curie. 31059 Toulouse Cedex 9, France

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-existing history of trauma can be found in 20% of the cases. Pain seems more frequent in malignant conditions but is not constant. Swelling usually appears at a late stage. 1 , 2 , 15 In our experience and in the literature, tumours of the foot and ankle

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Keijo T. Mäkelä Turku University Hospital and University of Turku, Finland, and the Finnish Arthroplasty Register

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Ove Furnes Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Geir Hallan Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Anne Marie Fenstad Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Ola Rolfson Sahlgrenska University Hospital and University of Gothenburg, Sweden, and the Swedish Hip Arthroplasty Register

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Johan Kärrholm Sahlgrenska University Hospital and University of Gothenburg, Sweden, and the Swedish Hip Arthroplasty Register

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Cecilia Rogmark Department of Orthopedics, Skåne University Hospital, Department of Clinical Sciences Malmö, Lund University, and the Swedish Hip Arthroplasty Register, Sweden

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Alma Becic Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, and the Danish Hip Arthroplasty Register

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Otto Robertsson The Swedish Knee Arthroplasty Register, Department of Orthopedics, Skåne University Hospital, and Department of Clinical Sciences, Orthopedics, Lund University, Sweden

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Annette W-Dahl The Swedish Knee Arthroplasty Register, Department of Orthopedics, Skåne University Hospital, and Department of Clinical Sciences, Orthopedics, Lund University, Sweden

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Antti Eskelinen Coxa Hospital for Joint Replacement, Tampere, Finland, and the Finnish Arthroplasty Register

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Henrik M. Schrøder Department of Orthopaedic Surgery, Naestved Hospital, Denmark, and the Danish Knee Arthroplasty Register

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Ville Äärimaa Turku University Hospital and University of Turku, Finland, and the Finnish Arthroplasty Register

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Jeppe V. Rasmussen Department of Orthopaedic Surgery, Herlev Hospital, University of Copenhagen, Denmark, and the Danish Shoulder Arthroplasty Register

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Björn Salomonsson Department of Orthopedics, Karolinska Institutet, Danderyds Sjukhus AB, Sweden, and the Swedish Shoulder Arthroplasty Register

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Randi Hole Haukeland University Hospital, Bergen, Norway, and the Norwegian Arthroplasty Register

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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, and the Danish Hip Arthroplasty Register

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23, 24 to 43 and ⩾ 44). They concluded that low volume hospitals performing ⩽ 11 Oxford III UKAs per year were associated with an increased risk of revision compared with higher volume hospitals, and unexplained pain as the revision cause was more

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Carsten Perka Center for Musculoskeletal Surgery, Charité Medical University Center, Berlin, Germany

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Maziar Mohaddes Hässleholms Hospital, Region Skåne, Hässleholm, Sweden
Orthopedics, Faculty of Medicine, Department of Clinical Sciences, Lund University, Malmö, Sweden

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Axel Ekkernkamp BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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Niklas Keller Harding Center for Risk Literacy, University of Potsdam, Faculty of Health Sciences, Potsdam, Germany

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Dirk Stengel BG Kliniken – Klinikverbund der gesetzlichen Unfallversicherung gGmbH, Berlin, Germany

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% Reason for revision, revised (O/E)  Unexplained pain 408 (0.96) 1198 (1.03) 193 (0.57) 1198 (1.15)  Infection 504 (0.88) 3184 (1.04) 821 (0.90) 3184 (1.05)  Socket fracture 205 (1.71) 62 (0.44) 20 (1

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