Ah. Schmidt et al., PERIPROSTHETIC METASTATIC CARCINOMA - PITFALLS IN THE MANAGEMENT OF 2CASES INITIALLY DIAGNOSED AS OSTEOLYSIS, The Journal of arthroplasty, 11(5), 1996, pp. 613-619
Periprosthetic osteolysis is a well-described phenomenon associated wi
th total hip arthroplasty. Two cases are presented in which apparently
healthy patients developed lytic lesions adjacent to cementless hip i
mplants. Despite atypical features, the lesions were initially attribu
ted to wear debris-induced osteolysis, and it was discovered during re
vision surgery that metastatic tumor was present. For one patient, if
the initial diagnosis had been correct, subsequent surgery and related
complications may have been avoided. II is important to consider the
entire differential of radiolucent bone lesions whenever a patient pre
sents with periprosthetic osteolysis. If revision surgery is not warra
nted on the basis of loosening, then a thorough medical examination, c
lose follow-up evaluation, and/or biopsy should be performed to rule o
ut metastatic disease.