Bone lysis in well-fixed cemented femoral components

W. J. Maloney, M. Jasty, Andrew Rosenberg, W. H. Harris

Research output: Contribution to journalArticle

246 Citations (Scopus)

Abstract

We have reviewed 25 cases of focal femoral osteolysis in radiographically stable, cemented femoral implants. In three hips retrieved at post-mortem from two patients, we have been able to make a detailed biomechanical and histological analysis. The interval between arthroplasty and the appearance of focal osteolysis on clincial radiographs ranged from 40 to 168 months, and in over 70% of the cases this did not appear until after five or more years. Few had significant pain and there was no relation to age, sex or original diagnosis. The most common site for osteolysis were Gruen zones 2 and 3 on the anteroposterior radiograph and zones 5 and 6 on the lateral radiograph. In 15 cases (60%), the area of osteolysis corresponded to either a defect in the cement mantle or an area of very thin cement. The rate of progression of these lesions was variable, but to date only one has progressed to gross loosening of the femoral component. The back-scatter scanning electron microscopic examination of serial sections and biomechanical testing of the post-mortem specimens demonstrated focal cement fracture around implants that were otherwise rigidly fixed. In eight cases from which tissue was available, histology showed a histiocytic reaction with evidence of particulate polymethylmethacrylate. We consider that this local fragmentation was the stimulus for local osteolysis in an otherwise stable cemented femoral component.

Original languageEnglish
Pages (from-to)966-970
Number of pages5
JournalJournal of Bone and Joint Surgery - Series B
Volume72
Issue number6
StatePublished - Jan 1 1990
Externally publishedYes

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Osteolysis
Thigh
Bone and Bones
Polymethyl Methacrylate
Arthroplasty
Hip
Histology
Electrons
Pain

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Bone lysis in well-fixed cemented femoral components. / Maloney, W. J.; Jasty, M.; Rosenberg, Andrew; Harris, W. H.

In: Journal of Bone and Joint Surgery - Series B, Vol. 72, No. 6, 01.01.1990, p. 966-970.

Research output: Contribution to journalArticle

Maloney, WJ, Jasty, M, Rosenberg, A & Harris, WH 1990, 'Bone lysis in well-fixed cemented femoral components', Journal of Bone and Joint Surgery - Series B, vol. 72, no. 6, pp. 966-970.
Maloney, W. J. ; Jasty, M. ; Rosenberg, Andrew ; Harris, W. H. / Bone lysis in well-fixed cemented femoral components. In: Journal of Bone and Joint Surgery - Series B. 1990 ; Vol. 72, No. 6. pp. 966-970.
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