Total revision of the hip using allograft to correct particle disease induced osteolysis: a case study

Total hip replacement is considered to be a highly successful and routine surgery; however, the internal components produce particles through friction and wear in the device. These particles are identified as one of the main reasons for total hip revisions. The generated, biologically active, particles provoke the formation of osteolytic areas through the inhibition of bone formation and increased fluid production. The resulting bone loss can be managed through the use of allograft bone in combination with bone chips and cement. In addition, implants constructed with highly porous trabecular metal can be used to further facilitate rapid and extensive tissue infiltration resulting in strong implant attachment. In this case study we show the use of a tibial allograft coupled with bone chips and cement to cover and support a lytic cyst in the proximal femur, distal to the greater trochanter. Additionally, we detail the use of a trabecular metal cup to halt the migration of the component into the acetabulum and promote greater fixation and bone ingrowth.