The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. A retrospective matched-pair series.

Goetz, Devon D.; Smith, Ella Thea; Harris, William H.

doi:10.2106/00004623-199408000-00002

Cited by 189 publications

(70 citation statements)

References 34 publications

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“…10,29 No difference in HO formation between the 2 groups was found. 53 Comparison of the results from studies in nonmatched pair is shown in Table 4.…”

Section: Tablementioning

confidence: 83%

“…In addition, a matched pair subgroup was included in the 2 studies. Therefore, there were 12 publications in category N, 4,6,15,19,22,26,29,30,31,51,54,56 10 in category R, 11,16,24,33,34,36,41,45,46,55 5 in category M, 4,10,29,40,53 and 4 in category S. 14,21,23,44 The mean postoperative follow-up period ranged from one year to 9.3 years. Among all these studies, one was designed to compare cemented, porous-coated, and hydroxyapatite-coated THR 16 ; one was to compare cemented, uncemented, and hybrid THR.…”

Section: Inmentioning

confidence: 99%

“…The superiority of either fixation method has not been proved conclusively because of the influences of confounding variables, such as patient age, sex, body weight, and diagnosis. 32 On the other hand, various studies have been designed to compare the clinical and radiological outcomes of cemented fixation with uncemented fixation using randomised clinical trials, 20,24 non-randomised comparison (both non-matched pair 6,22 and matched pair 10,29 ), and comparison in the same patient (bilateral THR using different methods on each side). 14,21 Therefore, no study has been able to draw a decisive conclusion because the conclusion was often limited to its own study method and result.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Review Article: Cemented or Uncemented Femoral Component in Primary Total Hip Replacement? A Review from a Clinical and Radiological Perspective

Chiu

et al. 2005

J Orthop Surg (Hong Kong)

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“…10,29 No difference in HO formation between the 2 groups was found. 53 Comparison of the results from studies in nonmatched pair is shown in Table 4.…”

Section: Tablementioning

confidence: 83%

Section: Inmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Review Article: Cemented or Uncemented Femoral Component in Primary Total Hip Replacement? A Review from a Clinical and Radiological Perspective

Chiu

et al. 2005

J Orthop Surg (Hong Kong)

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“…Periprosthetic osteolysis occurs in from 0% to 52% of hips among the reported series [2,6,8,18,22,[24][25][28][29]. These percentage values are influenced by different factors including the duration of follow-up, the head size and polyethylene cup thickness [16], linear and volumetric polyethylene wear [26], the age of the patient at surgery [26,28], fixation with or without cement [8,29] and the design and position of prosthetic components [2,17,23].…”

Section: Discussionmentioning

confidence: 99%

“…These percentage values are influenced by different factors including the duration of follow-up, the head size and polyethylene cup thickness [16], linear and volumetric polyethylene wear [26], the age of the patient at surgery [26,28], fixation with or without cement [8,29] and the design and position of prosthetic components [2,17,23]. Osteolyses are identified radiographically as ovoid or rounded lucencies which are usually limited to the proximal third of the femur (zones 5, 6 and 7 of Gruen) and the acetabular rim [10].…”

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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Differential expression of transforming growth factor‐α and macrophage colony‐stimulating factor/colony‐stimulating factor‐1R (c‐fms) by multinucleated giant cells involved in pathological bone resorption at the site of orthopaedic implants

al-Saffar

Revell

2000

Journal Orthopaedic Research

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The immunologic response to prosthetic biomaterial particles is characterized by macrophage-rich inflammatory infiltrate, formation of multinucleated giant cells, and aseptic loosening at the site of arthroplasty. We investigated the in vivo expression and tissue distribution of transforming growth factor alpha, macrophage colony-stimulating factor, and the receptor for colony-stimulating factor-1 at the site of bone erosion in patients with clinically failed orthopaedic implants (n = 30). The expression was further compared with that detected in the inflamed synovial membranes from patients with rheumatoid arthritis or osteoarthritis (n = 15) and one patient with osteoclastoma (giant cell tumour of bone). Immunostaining of the tissue demonstrated positivity for transforming growth factor alpha within the inflammatory macrophage and multinucleated giant cell infiltrate in the diseased synovial membrane and the bone-implant interface. A comparative analysis between the synovium and retrieval interface membranes (pseudosynovium) revealed a high level of expression of transforming growth factor alpha, with intense membrane staining on multinucleated giant cells in all failed arthroplasties with pseudosynovium. In addition, the frequency, antigenic phenotype, and pattern of transforming growth factor alpha expression on multinucleated giant cells in the interface were markedly similar to those observed for multinucleated giant cells in osteoclastoma. Multinucleated giant cells within the interface lacked the expression of macrophage colony-stimulating factor and colony-stimulating factor-1 receptor, whereas those at the bone surfaces exhibited strong immunoreactivity. The predominant expression of transforming growth factor alpha by multinucleated giant cells in the bone-implant interface and its similarity to osteoclastoma highlight the importance of assessing transforming growth factor alpha as a possible contributor to the development of bone-resorbing giant cells at the site of failed orthopaedic implants.

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The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. A retrospective matched-pair series.

Cited by 189 publications

References 34 publications

Review Article: Cemented or Uncemented Femoral Component in Primary Total Hip Replacement? A Review from a Clinical and Radiological Perspective

Review Article: Cemented or Uncemented Femoral Component in Primary Total Hip Replacement? A Review from a Clinical and Radiological Perspective

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

Differential expression of transforming growth factor‐α and macrophage colony‐stimulating factor/colony‐stimulating factor‐1R (c‐fms) by multinucleated giant cells involved in pathological bone resorption at the site of orthopaedic implants

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