Osteolysis in cemented total hip arthroplasty involving the OptiPlug cement restrictor: more than an incident?

The case report of a severe osteolytic reaction surrounding the OptiPlug cement restrictor in a 74-year-old male patient initiated a retrospective case series and closer investigation into the OptiPlug and its active compound, PolyActive. Not only did we find several cases of severe osteolysis in our own study population of 284 patients, several articles have lately described potential harmful side effects of the PolyActive material in humans. Although none of the articles have been based on large databases, we cannot guarantee the safety of this product. More research would help in our understanding of this phenomenon. Until then, we cannot recommend the use of the OptiPlug cement restrictor.