Focal lytic lesions associated with femoral stem loosening in total hip prosthesis.

Focal lytic lesions may occur in the proximal femur associated with loosening of the femoral component of a total hip prosthesis. During long-term follow-up of 62 patients with total hip prostheses, five such lesions developed. Histologically the lesions appear to be a histiocytic response to fragmented methylmethacrylate. Radiographically the lesions may suggest infection or neoplasm. Pathologic fracture may occur through large lesions. Experience in one case suggests that thorough removal of the tissue at the time of revision may be necessary to prevent recurrence. The recent reports of several malignant neoplasms developing in association with the femoral components of total hip replacements makes recognition of these benign focal lytic lesions even more important.

[1]  I. Watt.  Diagnosis—(ii) radiological , 1986 .

[2]  M. Swann.  Malignant soft-tissue tumour at the site of a total hip replacement. , 1984, The Journal of bone and joint surgery. British volume.

[3]  P. Ring,et al.  Osteosarcoma in association with total hip replacement , 1984, The Journal of bone and joint surgery. British volume.

[4]  W H Harris,et al.  The synovial-like membrane at the bone-cement interface in loose total hip replacements and its proposed role in bone lysis. , 1983, The Journal of bone and joint surgery. American volume.

[5]  Å. Carlsson,et al.  Aseptic loosening of hip prostheses. A histologic and enzyme histochemical study. , 1983, Clinical orthopaedics and related research.

[6]  N. Capener.  Proceedings and reports of universities, colleges, councils and associations. Abstracts. , 1959, The Journal of bone and joint surgery. British volume.

[7]  B. Ghelman,et al.  Radiologic diagnosis of loosening and infection in hip prostheses. , 1977, Journal of the Canadian Association of Radiologists.

[8]  L. Marmor.  Femoral loosening in total hip replacement. , 1976, Clinical orthopaedics and related research.

[9]  P. D. Wilson,et al.  Radiology of total hip replacements. , 1976, Clinical orthopaedics and related research.

[10]  W H Harris,et al.  Extensive localized bone resorption in the femur following total hip replacement. , 1976, The Journal of bone and joint surgery. American volume.

[11]  M. Semlitsch,et al.  Reaction of bone to methacrylate after hip arthroplasty: a long-term gross, light microscopic, and scanning electron microscopic study. , 1974, The Journal of bone and joint surgery. American volume.

[12]  P. Walker,et al.  Total surface hip replacement in the dog. A preliminary study of local tissue reaction. , 1974, Clinical orthopaedics and related research.

[13]  P. D. Wilson,et al.  Total hip replacement failures. A histological evaluation. , 1973, The Journal of bone and joint surgery. American volume.

[14]  D. Klein,et al.  Prostaglandins: stimulation of bone resorption in tissue culture. , 1970, Endocrinology.