Revision of aggressive granulomatous lesions in hip arthroplasty

Fourteen patients had revision arthroplasty for aggressive granulomatosis in 16 previously replaced cemented total hips. The revision was performed on average 8 years (range, 6-13 years) after the primary arthroplasty. Twelve patients had multifocal granulomatous lesions. Pain was the first clinical sign of the aggressive granulomatosis, beginning on average 1.7 years (range, 0.8-3.8 years) after the primary operation. One patient had a fracture of the femur due to large granulomas while waiting for revision. The patients were under follow-up evaluation for an average of 5.4 years (range, 4-7 years) after revision. Two patients had recurrence of aggressive granulomatosis at the original sites 4.5 and 6.5 years after revision. Eleven patients had good or excellent results of revision.