A patient operated on his/her hip complains of pain and/or is unsatisfied. You have discarded infection. What more?
• Objectivize clinical situation: pain intensity, functional limitations, level of activity.
• Other areas are cause of local pain: lumbar spine, abdominal hernias, genitourinary pathology.
• Suspect: loosening without radiolucent lines or migration, too thick / rigid stems, subluxation in extreme positions.
• Discard: poly wear, pseudotumors, particle disease, trunnionosis, ceramic fracture, ALVAL, allergies to metals.
• Reconsider: lower limb discrepancy, inadequate offset, insufficient abductors, tightened adductors, localized trochanteritis and impingement in flex-internal rotation.

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