Many surgeons treat progressive femoral osteolysis in association with a well-fixed stem with bone grafting but in uncontained
proximal defects the graft could get into the joint, raising a question regarding whether the osteolysis can be treated by
simple débridement without bone grafting. We investigated whether the curetted proximal osteolysis around an unrevised femoral
component progressed in size and whether this lesion would have a deleterious effect on fixation of the femoral component
in patients with isolated acetabular revision. We prospectively followed 21 patients (24 hips) who underwent acetabular revision
and curetting of femoral osteolysis. The minimum followup was 3 years (mean, 4.3 years; range, 3–7.4 years). By the latest
followup, no hips had major progression of the osteolytic defect through the followup period and none had any new osteolytic
lesions. All hips were judged stable and to have well-fixed acetabular cups and femoral stems. Provided a femoral component
is bone ingrown with osseointegration sufficient to provide long-term stability, the osteolytic defect is in the proximal
aspect of the femur, and the defect is uncontained, simple curettage may preserve femoral implant stability and may prevent
progression of osteolysis to another Gruen zone for at least 3 to 7 years.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
This work was supported by the research promoting grant from the Institute for Medical Science, Keimyung University, Daegu,
Korea.
Each author certifies that his institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.