Cross-linked polyethylene and bisphosphonate therapy for osteolysis in total hip arthroplasty: a case report

A 39-year-old woman underwent bilateral totalhip arthroplasty with conventional, ethyleneoxide–sterilised liners when she was a subject ina radiostereometric analysis study. Within 2 yearsshe had rapid polyethylene wear with aggressive,asymptomatic, and periprosthetic osteolysis onboth sides. Oral alendronate therapy halted theprogression of osteolysis over a year and revisionto cross-linked polyethylene liners was thenundertaken while one stem was curettaged andthe other revised. Radiostereometric analysisrevealed a 96% reduction in wear rate over 2years with the cross-linked liners. On stoppingalendronate treatment, aggressive osteolysis recurred on the curretaged but not on the revisedfemur.