Extensive localized bone resorption in the femur following total hip replacement

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

“…Extensive localized bone resorption resulting in loosening without infection was described by Harris et al (1976) in 4 hip arthroplasties. Osteolysis may be linear, i.e.…”

“…The resulting bone loss will enlarge the interface and ease the flow of joint fluid, resulting in higher transportation capacity of the debris and gradual loosening of the implant. Harris et al 1976Willert 1977 PE-particle Howie et al 1988 Metal-particle August 1986 Micromotion Ryd and linder 1989 Stress shielding Engh and Bobyn 1988 High fluid pressure Linder 1994Aspenberg and Van der Viis 1998Endotoxin Ragab et al 1999 Individual variations Matthews et al 2000 Sealed interface Schmalzried et al 1992 Various theories during the years regarding aseptic loosening Support for the above theory concerning effective joint space comes from the authors' own study on cemented acetabular components retrieved at autopsy (Schmalzried et al 1992b). Autopsy studies are important, since the well-functioning implant can be studied when no secondary changes such as osteoporosis and osteolysis have appeared.…”

“…Willert (1977) discussed the balance between production and elimination and hypothesized that when the equilibrium between production and elimination is disturbed, the accumulation of particles in the joint will cause loosening of the prosthesis. Several authors have found a correlation between loosening of prostheses and the amount of wear products produced from bone cement and PE (Harris et al 1976, Mirra et al 1982, Howie et al 1993, Mjöberg 1994. As cement ages, it becomes more brittle-which could be a source of cement particles.…”

“…As cement ages, it becomes more brittle-which could be a source of cement particles. Harris et al (1976) reported 4 cases with extensive osteolysis in cemented hip artroplasties without any signs of infection. They postulated that the fibrous tissue between the bone and the cement could play a major role in the initiation of the osteolysis.…”

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

“…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.…”