Replacement Of Osteolytic Defects In Revision Hip Replacement Surgery

Uģis Mihelsons, Dārta Jakovicka, Sintija Kukaine, Pēteris Studers (Scientific Advisor)

Research output: Contribution to conferenceAbstractpeer-review


Background and aim. Periprosthetic osteolysis is one of the most common reasons for revision hip arthroplasty, affecting approximately 35% of patients after primary surgery, according to the latest Annual Report from Swedish Hip Arthroplasty Register. This paper aims to study the treatment methods used in the Hospital of Traumatology and Orthopaedics (Riga, Latvia) and their therapeutic possibilities in patients with osteolytic defects after arthroplasty by performing the clinical and radiological evaluation.
Materials and methods. The single-centre study included 65 patients who underwent revision hip surgery with osteolytic lesions between 2011 and 2019, but the development of infection in the operated hip was an exclusion criterion. Clinical data were obtained from the patients' medical records using a predefined study protocol. In addition, the patients' preoperative radiographs were interpreted using the DeLee and Charnley and Gruen classification of hip prosthesis zones.
Results. The mean time of onset of osteolysis was 16.5 years (min - 6 yrs.; max - 27 yrs.). 93.8% of all patients reported pain, in 60% of them - for more than one year. 65% suffered from pain at night and 77% from morning stiffness in the joint. Of all revision surgeries, 65% retained acetabular and 51% femoral components. The radiologically most affected area around the femoral component was a zone I (Gruen classification) and zone I according to the classification of DeLee and Charnley. 4.6% of patients with pain showed no signs of osteolysis on preoperative radiographs, although they suffered from pain.
Conclusions. In summary, this study shows that the average development time of periprosthetic osteolysis is more than a decade from the time of primary surgery. Still, the determination of the exact onset of osteolysis is complicated by several contributing factors. The high percentage of patients who have had pain for more than a year demonstrates the importance of shortening the time from onset of symptoms to initiation of treatment. Radiologically, the most affected area according to both classifications used in the study was a zone I, which leads us to pay special attention to this zone when evaluating the radiograph when osteolysis loosening is suspected. Clinical symptoms do not always agree with radiological findings, as not all patients with pain had signs of osteolysis on preoperative radiographs.
Original languageEnglish
Number of pages1
Publication statusPublished - 10 Apr 2021
EventBaltic Surgical Conference for Medical Students 2021 - Rīga, Latvia
Duration: 10 Apr 202110 Apr 2021


ConferenceBaltic Surgical Conference for Medical Students 2021
Internet address


  • Arthroplasty
  • Osteolysis
  • Hip arthroplasty
  • Prosthesis
  • Radiology

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)


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