Osteolysis in total hip arthroplasty after head and inlay revision surgery.

Wear debris seems to be the most likely reason for osteolysis in THA. The aim was to show the influence of head and acetabular liner revision surgery on osteolytic zones around the femoral component. Can head and inlay revision surgery reduce the size of the osteolytic zones around the femoral component? Which patients could benefit? 47 patients (51 hips), who had undergone THA head and inlay revision surgery between 1999 and 2011, were reviewed. The mean lifetime for the prosthesis was 15.1 years (8-26, standard deviation 4.5) and the mean follow-up for head and inlay was 39.2 months (12-113, standard deviation 30). The heads used in revision surgery were made of metal (26) and ceramics (25). In 36 cases a ultra-high-molecular-weight polyethylene inlay was taken, in 15 cases a regular PE-inlay. We compared the pre-surgical and follow-up anterior-posterior X-rays. The mean size of radiolucent areas before revision surgery was 147 sq.mm (5-389 sq.mm, standard deviation 115). Thirty-nine months (12-113) after surgery, their mean size was 145 sq.mm (7-604 sq.mm, standard deviation 124). Radiolucent zones exceeding 100 sq.mm could be reduced by an average of 28% in 18 out of 29 cases. The results showed an improvement in 29 out of 51 cases and a stop of progress in one case. According to the findings there may be a benefit for patients with big radiolucent areas.