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Updated: Feb 5, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Rapid Complete Acetabular Destruction in Metal-on-Metal Total Hip Arthroplasty
Christian A Pean1, Antonios Tsismenakis1, Diana Douleh1
1Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY (Dr. Pean, Dr. Tsismenakis, and Dr. Schwarzkopf), and Vanderbilt University Medical Center, Nashville, TN (Dr. Douleh).
Abstract:
Adverse local tissue reaction, osteolysis, and subsequent increased incidence of failure have been associated with metal-on-metal (MoM) total hip arthroplasty (THA). We present the case of a 68-year-old woman with rheumatoid arthritis who has undergone left THA with a MoM bearing. Seven years postoperatively, she presented with 6 weeks of severe left hip pain. Sequential radiographs and advanced imaging demonstrated a rapid onset of extensive acetabular osteolysis with pelvic discontinuity and pseudotumor formation. She underwent revision THA using a cup-cage construct with a satisfactory outcome. In this article, we review current evidence-based management options for pelvic discontinuity, as well as other complications related to MoM THA.
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