Cross-linked polyethylene and bisphosphonate therapy for osteolysis in total hip arthroplasty: a case report.
A 39-year-old woman underwent bilateral total hip arthroplasty with conventional, ethylene oxide-sterilised liners when she was a subject in a radiostereometric analysis study. Within 2 years she had rapid polyethylene wear with aggressive, asymptomatic, and periprosthetic osteolysis on both sides. Oral alendronate therapy halted the progression of osteolysis over a year and revision to cross-linked polyethylene liners was then undertaken while one stem was curettaged and the other revised. Radiostereometric analysis revealed a 96% reduction in wear rate over 2 years with the cross-linked liners. On stopping alendronate treatment, aggressive osteolysis recurred on the curretaged but not on the revised femur.
O'Hara
L J
LJ
Perth Orthopaedic Institute, Western Australia, Australia. hahara@aol.com
Nivbrant
B
B
Röhrl
S
S
D000284:Administration, Oral; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D020959:Polyethylene / Q000494:pharmacology*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012086:Reoperation; D016896:Treatment Outcome
D004164:Diphosphonates; D020959:Polyethylene