Cross-linked polyethylene and bisphosphonate therapy for osteolysis in total hip arthroplasty: A case report

LJ O’Hara, B Nivbrant
Perth Orthopaedic Institute, Western Australia, Australia

S Röhrl
Consultant Orthopaedic Surgeon, University Hospital Umea, Umea, Sweden

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.
 
Journal of Orthopaedic Surgery2004;12(1):114-121
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last updated 30 June, 2004