Azetabuläre Osteolysen bei Hüfttotalendoprothese - wann kann die Pfanne belassen werden?

Translated title of the contribution: Acetabular Osteolysis in Total Hip Replacement - When to Retain the Cup?

B. Lutz*, M. Faschingbauer, R. Bieger, H. Reichel, T. Kappe

*Corresponding author for this work


Periacetabular osteolysis is a frequent long-term complication of cementless total hip arthroplasty. The decision whether to retain or to revise a cup in the presence of osteolysis remains a challenge. The options are regular clinical and radiological check-ups, isolated liner exchange with and without bone grafting, and complete cup revision. Thorough preoperative diagnostics, including a medical history, examination and imaging, are mandatory for correct decision making. In most patients, computed tomography is useful to assess periacetabular osteolysis. If the cup is well-fixed and positioned in an asymptomatic patient without progressive osteolysis and no implant defect or higher grade polyethylene wear and no signs of infection, continuous clinical and radiological monitoring is preferred. If imaging reveals cup loosening, malposition, osteolysis localised in a weight-bearing area, imminent or present periprosthetic fractures, rapid progressive osteolysis, implant defects or massive inlay wear, surgical treatment may be preferred. Cup revision is usually performed in such patients. If the cup is well-positioned and well-fixed in the X-ray, the procedure has to be discussed with the patient individually. Apart from patient-specific risk factors, the risk of further progression has to be assessed. Isolated liner exchange can be performed if the patient is asymptomatic and the cup proves to be stable intraoperatively. It is still unclear whether filling osteolyses through screw holes or osseous windows is of long-term benefit.

Translated title of the contributionAcetabular Osteolysis in Total Hip Replacement - When to Retain the Cup?
Original languageGerman
JournalZeitschrift fur Orthopadie und Unfallchirurgie
Issue number4
Pages (from-to)377-384
Number of pages8
Publication statusPublished - 01.08.2016
Externally publishedYes

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)


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