The surface finish of a femoral stem plays an important role in the longevity of cemented
total hip arthroplasty. In efforts to decrease the rate of aseptic loosening, some
prostheses have been designed to have a roughened surface that enhances bonding between the
prosthesis and cement, but clinical outcomes remain controversial. We present a rare case of
massive osteolysis with extreme femoral expansion that developed after cemented revision
total hip arthroplasty. The destructive changes in the femur were attributable to abnormal motion of the stem and were aggravated by the roughened precoated surface of the long femoral component.
Revision surgery using a total femur
prosthesis was performed because there was insufficient remaining bone to fix the new
prosthesis. The surgical technique involved wrapping
polypropylene meshes around the
prosthesis to create an insertion for the soft tissue, which proved useful for preventing
muscular weakness and subsequent dislocation of the hip.