[Is osteolysis associated with a stable total hip replacement asymptomatic?]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Context:

• Periprosthetic osteolysis is a known complication of cementless total hip arthroplasty.
• Previous reports suggested asymptomatic progression of osteolysis.
• This study investigates the clinical presentation of osteolysis in stable cementless hip prostheses.

Purpose:

• To evaluate the symptomatic status of periprosthetic osteolysis in stable cementless total hip prostheses.
• To detail the clinical presentation of this hip arthroplasty complication.
• To challenge the assumption of asymptomatic osteolysis progression.

Summary:

• A study of 76 hips with stable ABG I cementless prostheses found 80% were symptomatic before revision surgery.
• Pain and instability were the primary symptoms, with a significant difference in Harris hip scores between symptomatic (68) and asymptomatic (82) patients.
• Osteolysis around stable cementless hip prostheses is generally symptomatic, with pain being the most common symptom.

Impact:

• Highlights that periprosthetic osteolysis is usually symptomatic, contrary to some previous findings.
• Emphasizes the potential for significant joint impairment and discomfort even in the absence of periprosthetic fracture.
• Recommends vigilance for both symptomatic and asymptomatic cases, particularly those with suboptimal prosthesis designs or pairings.