UNPREDICTABLE PROGRESSION OF OSTEOLYSIS FOLLOWING CEMENTLESS HIP-ARTHROPLASTY - 24 FEMORAL COMPONENTS FOLLOWED FOR 6-10 YEARS

We reviewed 24 hips that developed femoral osteolytic lesions followin g cementless total hip replacement with a Porous-Coated Anatomic prost hesis after a mean of 8 (6-10) years, 15 of the hips showed hardly any radiographic deterioration in the osteolysis. 2 became much worse wit h dramatic loss of bone stock, Both of these hips required revision of the acetabular component as well as bone grafting of the otherwise we ll-fixed femoral component, The remaining 7 hips showed mild-to-modera te enlargement of the lesions, All 24 hips were asymptomatic. Blood te sts and bone scintigraphy were of no predictive value in assessing the probable progression of the lesions. Serial radiography remains the c ornerstone of the monitoring of osteolysis, following cementless hip r eplacement, the extent of bone loss being usually far greater than ind icated by radiographic examination.