We are reporting four cases of extensive, localized bone resorption
adjacent to a rigidly anchored, cemented total hip replacement. None of
these hips showed evidence of infection on clinical, bacteriological, or
pathological evaluation. The tissue from the regions of osteolysis showed
sheets of macrophages and foreign-body giant cells invading the femoral
cortices. Abundant methylmethacrylate particulate debris was present in the
tissues, but polyethylene wear debris was absent. The histological
appearance of this tissue resembled that reported about loosened total hip
implants with the exception of the synovial-like layer at the cement
surface. The cases reported here show that aggressive bone lysis may occur
around stable cemented total hip arthroplasties without the presence of
sepsis or malignant disease.