Periprosthetic femoral osteolysis around an uncemented nonmodular Moore prosthesis.

Abstract

Periprosthetic osteolysis is a major problem in total joint arthroplasty surgery today. The particulate debris from ultrahigh-molecular-weight polyethylene, polymethyl methacrylate, and corrosion products from modular connections have been implicated in this process. A case of femoral osteolysis at the tip of a nonmodular Moore prosthesis, in the absence of polyethylene, polymethyl methacrylate, and modular connections, is reported. In the area of osteolysis, histochemical and in situ hybridization techniques established the expression of messenger ribonucleic acid encoding for certain cytokines implicated in bone resorption, preferentially in the area of osteolysis. This case illustrates that the etiology of periprosthetic osteolysis is multifactorial and can occur in the absence of polyethylene, methacrylate, or modular components. All joint implants should be monitored for the development of this complication.