The need for a better roentgenographic evaluation of implant behavior in long-term prosthetic replacement of the proximal femur was considered. The authors present the results of a group of 13 patients belonging to a wide range of ages, with more than ten-years follow-up after tumor resection, and replacement characterized by bipolar cup and non-cemented stem. A new X-ray film acquisition and evaluation method was devised. Results confirmed the good behavior of bipolar reconstructions in patients of different ages, whose sockets were still intact. In younger patients, the prevalent bipolar movement was in the outer bearing, thus limiting polyethylene particulate debris formation. However, debris formation did not significantly affect the bone/stem relationship as only one loose stem was observed in a bone submitted to radiotherapy.
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