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Extensive localized bone resorption in the femur following total hip replacement

J Bone Joint Surg Am, 1976 Jul 01;58(5):612-618
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Abstract

Extensive localized bone resorption within the femur was observed after four total hip replacements. The amount and location of the resorption suggested the presence of infection or tumor, but there was no evidence of either condition and the roentgenographic appearance differed from that associated with a loose uncemented endoprosthesis or a grossly loose femoral component of a total hip replacement. At reoperation the femoral components were not rigidly fixed but were only slightly loose. Histologically there were sheets of macrophages, a few giant cells, and multiple small fragments of a birefringent material, but no inflammatory cells. While the exact mechanism of this serious complication is unclear, the findings suggest that a benign, non-inflammatory, adverse tissue response can occur in relation to the femoral components of total hip replacements that are not rigidly fixed. In all four hips, reimplantation of a new total hip replacement was successful after follow-up of thirteen to eighteen months.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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