Catastrophic Periprosthetic Osteolysis in Total Hip Arthroplasty at 20 Years: A Case Report and Literature Review.

Xing, D; Li, R; Li, JJ; Tao, K; Lin, J; Yan, T; Zhou, D

Catastrophic Periprosthetic Osteolysis in Total Hip Arthroplasty at 20 Years: A Case Report and Literature Review.

Xing, D Li, R Li, JJ Tao, K Lin, J Yan, T Zhou, D

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Orthop Surg, 2022, 14, (8), pp. 1918-1926
Issue Date:: 2022-08

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Field	Value	Language
dc.contributor.author	Xing, D
dc.contributor.author	Li, R
dc.contributor.author	Li, JJ
dc.contributor.author	Tao, K
dc.contributor.author	Lin, J
dc.contributor.author	Yan, T
dc.contributor.author	Zhou, D
dc.date.accessioned	2023-01-18T05:26:03Z
dc.date.available	2022-05-13
dc.date.available	2023-01-18T05:26:03Z
dc.date.issued	2022-08
dc.identifier.citation	Orthop Surg, 2022, 14, (8), pp. 1918-1926
dc.identifier.issn	1757-7853
dc.identifier.issn	1757-7861
dc.identifier.uri	http://hdl.handle.net/10453/165133
dc.description.abstract	BACKGROUND: Periprosthetic osteolysis is a serious complication following total hip arthroplasty (THA). However, most orthopedic surgeons only focus on bone loss and hip reconstruction. Thus, it was required to understand the treatment algorithm for periprosthetic osteolysis integrally. CASE PRESENTATION: A 52-year-old Asian male presented with chronic hip pain. A mass appeared on the medial side of the proximal left thigh at more than 20 years after bilateral THA. Radiographs revealed catastrophic periprosthetic osteolysis, especially on the acetabular side. Large amounts of necrotic tissue and bloody fluids were thoroughly debrided during revision THA. A modular hemipelvic prosthesis was used for revision of the left hip. Four years later, the patient presented with right hip pain, where a mass appeared on the medial side of the proximal right thigh. A primary acetabular implant with augment was used for revision of the right hip. Laboratory evaluation of bloody fluid retrieved from surgery revealed elevated levels of inflammatory markers. CONCLUSION: Inflammatory responses to polyethylene wear debris can lead to severe bone resorption and aseptic loosening in the long-term following THA. Therefore, in spite of revision THA, interrupting the cascade inflammatory might be the treatment principle for periprosthetic osteolysis.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Orthop Surg
dc.relation.isbasedon	10.1111/os.13322
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences
dc.subject.mesh	Arthroplasty, Replacement, Hip
dc.subject.mesh	Hip Prosthesis
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Osteolysis
dc.subject.mesh	Pain
dc.subject.mesh	Prosthesis Design
dc.subject.mesh	Prosthesis Failure
dc.subject.mesh	Reoperation
dc.subject.mesh	Humans
dc.subject.mesh	Osteolysis
dc.subject.mesh	Pain
dc.subject.mesh	Prosthesis Failure
dc.subject.mesh	Arthroplasty, Replacement, Hip
dc.subject.mesh	Reoperation
dc.subject.mesh	Prosthesis Design
dc.subject.mesh	Hip Prosthesis
dc.subject.mesh	Middle Aged
dc.subject.mesh	Male
dc.title	Catastrophic Periprosthetic Osteolysis in Total Hip Arthroplasty at 20 Years: A Case Report and Literature Review.
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	Australia
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
utslib.copyright.status	open_access	*
dc.date.updated	2023-01-18T05:25:57Z
pubs.issue	8
pubs.publication-status	Published
pubs.volume	14
utslib.citation.issue	8

Abstract:

BACKGROUND: Periprosthetic osteolysis is a serious complication following total hip arthroplasty (THA). However, most orthopedic surgeons only focus on bone loss and hip reconstruction. Thus, it was required to understand the treatment algorithm for periprosthetic osteolysis integrally. CASE PRESENTATION: A 52-year-old Asian male presented with chronic hip pain. A mass appeared on the medial side of the proximal left thigh at more than 20 years after bilateral THA. Radiographs revealed catastrophic periprosthetic osteolysis, especially on the acetabular side. Large amounts of necrotic tissue and bloody fluids were thoroughly debrided during revision THA. A modular hemipelvic prosthesis was used for revision of the left hip. Four years later, the patient presented with right hip pain, where a mass appeared on the medial side of the proximal right thigh. A primary acetabular implant with augment was used for revision of the right hip. Laboratory evaluation of bloody fluid retrieved from surgery revealed elevated levels of inflammatory markers. CONCLUSION: Inflammatory responses to polyethylene wear debris can lead to severe bone resorption and aseptic loosening in the long-term following THA. Therefore, in spite of revision THA, interrupting the cascade inflammatory might be the treatment principle for periprosthetic osteolysis.

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