Localized osteolysis in stable, non-septic total hip replacement.

Jasty, Murali; Floyd, Waldo E.; Schiller, A L; Goldring, Steven R.; Harris, William H.

doi:10.2106/00004623-198668060-00014

Cited by 310 publications

(84 citation statements)

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“…They postulated that the fibrous tissue between the bone and the cement could play a major role in the initiation of the osteolysis. In a retrieval study, Jasty et al (1986) reported 4 cases with bone resorption in a cemented hip replacement with no evidence of infection. The histomorphometrical analysis revealed polymethylmethacrylate debris in the tissues and the authors proposed that micromotion initiates cement failure, with a subsequent release of cement particles.…”

Section: Cementmentioning

confidence: 99%

“…In some patients, this can be explained by their age, activity level or body weight, but in many patients the explanation is unknown. Jasty et al (1986) proposed that osteolysis may be related to an adverse cellular response that might predict implant loosening. In an in vitro study, Matthews et al (2000a) reported that human macrophages from three different donors released different amounts of cytokines when exposed to endotoxin-free PE particles.…”

Section: Individual or Genetic Variationsmentioning

confidence: 99%

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Aseptic loosening, not only a question of wear: A review of different theories

et al. 2006

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Section: Cementmentioning

confidence: 99%

Section: Individual or Genetic Variationsmentioning

confidence: 99%

Aseptic loosening, not only a question of wear: A review of different theories

et al. 2006

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“…Such communication can be present from the time of implantation, if the cement mantle is not circumferential and homogenous; or if there are cement voids [22], or cracks occuring before or after stem loosening [22,36]. When such communication exists, osteolysis may develop [1,23,32]. Anthony et al [1] described the flow of particleloaded fluid at the stem-cement interface as a possible cause of femoral osteolysis in Exeter cemented femoral stems.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, inconsistent stem centralisation and finger-packing of the cement led to areas of incomplete cement mantle, which were considered detrimental to the long-term survivorship of the arthroplasty [1,21,23].…”

Section: Introductionmentioning

confidence: 99%

Favourable mid-term results of the VerSys CT polished cemented femoral stem for total hip arthroplasty

Valle

Zoppi

Salvati

2006

International Orthopaedics (SICOT)

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“…Less than 10% of osteolyses become massive and lead to significant loss of bone stock [15]. Massive osteolyses have been described on loose and well-fixed femoral or/and acetabular components of cemented [3,10,[12][13][14][19][20][21] and uncemented [15,17,27] hip prostheses. The usual macroscopic findings are of cavities filled with yellow caseous material.…”

Section: Discussionmentioning

confidence: 99%

Massive pelvic and femoral pseudotumoral osteolysis secondary to an uncemented total hip arthroplasty

Jeanrot

Ouaknine

Anract

et al. 1999

International Orthopaedics

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A 51 year-old man developed an extensive osteolytic response to wear debris in an uncemented porous-coated total hip arthroplasty, with metal/polyethylene interface, which had been implanted eighteen years previously. This reaction, which involved the upper femur and the ilium, produced a mass which compressed the pelvic viscera. IntroductionOsteolysis is a frequent complication which affects the outcome of total hip arthroplasty. Since Charnley's first description concerning a cemented prosthesis in 1968 [5], osteolysis has been described as occurring around loose and well-fixed femoral and acetabular implants of cemented and cementless prostheses. This complication results from an inflammatory foreign body reaction to the different prosthetic components and wear debris from the articulating surfaces and the interfaces has been implicated as a causative factor [1]. Polymethylmethacrylate cement, polyethylene, metal and more recently ceramic [27] debris may be the cause of osteolytic response, although polyethylene debris is considered to be the most damaging. Phagocytosis of debris by macrophages releases the mediators of osteolysis. Lack of bone ingrowth in uncemented implants or defective fixation at the bone-cement interface in cemented prostheses play a role in producing particles and activating the reaction [1,10,27]. Once radiologically identified, the majority of the osteolytic lesions remain stable over many years or else evolve slowly [15,18,25,26,28]. A minority progress, mimicking a tumour [3, 10, 12-14, 17, 19-21, 27]. These massive osteolyses constitute a real clinical problem, because of the eventual failure of the implant and technical difficulties at revision due to bone loss. We report an unusual case of an aggressive pelvic and femoral osteolysis secondary to an uncemented hip prosthesis which had been implanted eighteen years previously. Case reportIn March 1995, a black male aged 51 years was admitted into our Department of Orthopaedic Surgery with pain and swelling affecting the proximal third of the left thigh. He had the sequelae of neonatal cerebral palsy (Little's syndrome) and had started to walk with an aid at the age of seven years. In December 1977, at the age of 34 years, he was treated in another hospital for a femoral neck non-union which occurred two years after a femoral neck fracture. Replacement arthroplasty was undertaken using an uncemented

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Localized osteolysis in stable, non-septic total hip replacement.

Cited by 310 publications

References 0 publications

Aseptic loosening, not only a question of wear: A review of different theories

Aseptic loosening, not only a question of wear: A review of different theories

Favourable mid-term results of the VerSys CT polished cemented femoral stem for total hip arthroplasty

Massive pelvic and femoral pseudotumoral osteolysis secondary to an uncemented total hip arthroplasty

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