AORI Home | Hip research | Knee research
MANAGEMENT OF PATIENTS WITH ACETABULAR SOCKET WEAR
AND PELVIC OSTEOLYSISAlexandra M. Claus, MD, PhD †
Tim A. Walde, MD‡
Serena B. Leung, MS ‡
Rebecca L. Wolf ‡
Charles A. Engh, Sr., MD ‡
‡ Investigation performed at Anderson Orthopaedic Research Institute, Alexandria, VA 22307
†Fakultaet fuer Klinische Medizin der Universitaet Heidelberg, Klinikum Mannheim gGmbH, Orthopaedische Universitaetsklinik, Mannheim, Germany
ABSTRACT
Polyethylene wear and pelvic osteolysis are the most common late complications associated with stable cementless total hip implants. This manuscript describes the diagnostic strategies and treatment algorithm used at Anderson Orthopaedic Clinic for patients with wear and pelvic osteolysis. This evolving management strategy is based on our experiences and ongoing research. We discuss patient selection, the evaluation of acetabular liner wear, the diagnosis of pelvic osteolysis, the timing of revision, and treatment strategies. According to this algorithm, we revise asymptomatic patients with pending or complete wear-through of the acetabular liner. We also recommend revision for most symptomatic patients with pelvic osteolysis and for patients with large pelvic osteolytic bone defects or a documented increase in osteolytic lesion size in an area of the cementless acetabular component in which a load transfer between the implant and the surrounding bone is likely to occur.
This research was funded, in part, by Inova Health Care Services, Virginia.
Please address all correspondence to:
Janice Black, Editor
Anderson Orthopaedic Research Institute
P.O. Box 7088
Alexandria, VA 22307
Phone: (703) 619-4424
FAX: (703) 799-5982