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Re: Osteolysis - Revision & extensive bone grafting

From: Darlys email:
Date: 14 Aug 2001
Time: 23:54:42
Remote Name:



I felt a real need to respond to your post. Sounds like you have been on a long and challenging road. You mentioned that your prosthesis is not loose, even though you have extensive osteolysis. This can happen, especially with an uncemented prosthesis, where polyethylene debris from the polyethylene acetabular (cup) liner causes bone resorption, resulting in osteolytic lesions.

You said your revision could be a very complicated surgery, requiring extensive bone grafting, a metal cage, and the possiblity that you will not have enough bone left to support a prosthesis. Fiona, with your serious and complicated hip condition, I want you to know and realize how important it is to find a surgeon, perferably a "hip specialist", who specialized in revision hip surgery. This is by far the MOST IMPORTANT thing you can do for yourself to insure a successful outcome. Technical surgical experience and talent is so extremely important in cases this serious. If you find the right surgeon, it is possible that even if there isn't enough bone stock left (on the cup side) to place an acetabular prosthesis in place, they may be able to do a "total acetabular allograft", which would eliminate the need for a Girdlestone procedure. With this procedure (total acetabular allograft) they use a cadaver acetabulum to replace your missing bone. It is held in place with screws and plates, then they place the metal cage over the allograft to support the graft, then cement a cup prosthesis into the cage. If this is carried out by a talented hip surgeon, the result can be a very stable hip reconstruction. I wish you only the very best outcome for your hip condition. If you would like to talk to me, feel free to email me at the above address. I would be more than happy to visit with you. Take care, Darlys

Last changed: August 14, 2001