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What is the outcome of treatment for osteolysis?

Dr. Maloney is Elsbach-Richards Professor of Surgery, and Professor and Chairman, Department of Orthopaedic Surgery, Stanford University, Stanford, CA. Dr. Rosenberg is Professor of Surgery, and Director and Fellowship Director, Adult Reconstructive Orthopedics, Rush Medical College, Chicago, IL.

*The Implant Wear Symposium 2007 Clinical Work Group included John J. Callaghan, MD, John M. Cuckler, MD, Jorge O. Galante, MD, DMSc, Alejandro González Della Valle, MD, Stuart B. Goodman, MD, PhD, James I. Huddleston, MD, Lynne C. Jones, PhD, David G. Lewallen, MD, Henrik Malchau, MD, PhD, William Maloney, MD, Amanda Marshall, MD, Wayne Paprosky, MD, Hollis G. Potter, MD, Michael D. Ries, MD, Aaron Rosenberg, MD, Thomas P. Sculco, MD, Bernard N. Stulberg, MD, Audrey K. Tsao, MD, and Timothy Wright, PhD.

Dr. Maloney or a member of his immediate family has received research or institutional support from DePuy, Medtronic, Synthes, and Zimmer; has received royalties from Zimmer and Wright Medical Technology; and is a consultant to or an employee of Wright Medical Technology. Dr. Rosenberg or a member of his immediate family has received research or institutional support, has received royalties, has stock or stock options held in, and serves as a consultant to Zimmer.

Periprosthetic osteolysis secondary to wear-induced particle generation is a common long-term complication of hip and knee replacement and frequently results in the need for revision surgery. Management of significant bone defects remains a surgical challenge. Surgical intervention must address the wear particle generator (usually, but not always, the bearing surface), the osteolytic defects, and implant-related issues, primarily fixation and alignment. Indications for surgical intervention in the absence of loosening and pain are not well established. In general, patient age and activity level, the location and size of the osteolytic defect, and the clinical record of the implant system will dictate treatment choices.