This is a rather unusual situation but shows the problems that can arise in the case where other disease processes are already at work.

Abstract

Early periprosthetic osteolysis following total hip replacement (THR) as a result of septic etiology has been well understood. Periprosthetic bone loss as a result of metastatic infiltration is an uncommon and infrequent cause of early, progressive loosening of joint replacement prosthesis. Proximal femur has been the most common site of involvement compared to acetabular prosthesis.

The rarity of this clinical entity can lead to delay in definitive diagnosis and management, thus affecting the final outcome. Breast is the commonest site of carcinoma in female patients despite which not many cases of periprosthetic metastasis have been reported in the literature. We present the first case of extensive, isolated periacetabular bone destruction following a THR in a 59 years old female patient with a history of breast carcinoma.

Patients with known primary malignancy should be screened thoroughly before operation and should be followed regularly after joint replacement surgery to detect any metastatic foci around the prosthesis.

 

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