The evaluation and management of peri-acetabular osteolysis

Total hip arthroplasty is one of the most successful and cost-effective surgical procedures in medicine and continues to be the most effective treatment for advanced osteoarthritis of the hip. The bearing surface remains one of the most critical factors limiting long-term survival of this procedure. This is partly due to the ceramic, metal, and polyethylene wear particles that can spur an inflammatory response within the body that induces periprosthetic bone resorption. In the case of wear of the bearing surface and resorption of acetabular bone, this can result in a confusing diagnostic scenario and an appropriate algorithm must be followed to diagnose, observe, and surgically manage these complex patients.