PMC5306992_01
Radiographs of the left hip joint after THA. (a) The initial radiograph after THA. (b) At 4 weeks after THA. (c) At 8 weeks. (d) At 10 weeks.
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The left hip pain disappeared after surgery, but the bone tunnels were slightly enlarged on the radiograph 4 weeks after operation. They enlarged gradually and developed osteolysis of 10 mm in diameter at 10 weeks in the radiographs (Figure 1).
Coronal view of computed tomography showing osteolysis clearly ((a)-(d)).
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Computed tomography (CT) showed the osteolysis clearly (Figure 2).
Magnetic resonance imaging at 10 weeks after THA. (a) T1-weighted image. (b) T2 star-weighted image. (c) T2 Short-TI Inversion Recovery (STIR) image.
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T2 star-weighted images. The area surrounding the mass had low intensities on T1-weighted images and high intensities on T2 star-weighted images (Figure 3). The patient had no pain, and inflammatory sign was not observed on the operated site. There was no sign of infection on blood biochemical examinations. The removal of the Ethibond sutures and debridement were performed to prevent progressive osteolysis and a pathological fracture of the greater trochanter.
Histological examination showing the foreign body reaction granuloma with giant cell formation and proliferation of small blood vessels (hematoxylin and eosin stain; magnification: 100x).
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Histological examination showed the granuloma reaction to a foreign body with giant cell formation and proliferation of small blood vessels (Figure 4).
Radiographs of the left hip joint after the removal of the Ethibond suture and the granulation tissue. Bone tunnels gradually decrease and disappear. There is no evidence of osteolysis of the greater trochanter at 10 months after the second surgery. (a) At 1 month after the second surgery. (b) At 2 months. (c) At 3 months. (d) At 10 months.
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There was no evidence of osteolysis of the greater trochanter in the radiograph at 10 months after the second operation (Figure 5).