Corrosion of cemented titanium femoral stems.

Cemented titanium stems in hip arthroplasty are associated with proximal cement-stem ebonding and early failure. This was well publicised with the 3M Capital hip. However, corrosion in this setting has been reported with only one stem design and is less widely accepted. We present a series of 12 cemented titanium Furlong Straight Stems which required revision at a mean of 78 months for thigh pain. At revision the stems were severely corroded in a pattern which was typical of crevice corrosion. Symptoms were eliminated after revision to an all-stainless steel femoral prosthesis of the same design. We discuss the likely causes for the corrosion. The combination of a titanium stem and cement appears to facilitate crevice corrosion.

Total hip arthroplasty for hemophilic arthropathy.

From 1969 until 1985, 39 total hip arthroplasties (THAs) were performed in 38 patients for hemophilic arthropathy. The median age of patients at operation was 48.1 years. Twenty-two of these hip replacements in 21 patients were reviewed clinically and roentgenographically with a median follow-up study of 7.6 years. Five of the 22 hips have been revised and three are likely to require revision in the near future. The incidence of revision is compared to other studies of THA in young patients and the influence of human immunodeficiency virus infection is examined. Total hip arthroplasty in the hemophiliac is believed to be an appropriate operation for disabling hemophilic arthropathy.

Fibrous dysplasia with locally aggressive malignant change.

This is a case report of a tumour which showed all the histological features of fibrous dysplasia without any features of high-grade malignancy, yet had become locally aggressive, causing cortical erosion and extension into soft tissue. Fibrous dysplasia is a well-recognised entity that encompasses monostotic lesions, polyostotic involvement and Albright's syndrome [6, 8]. Lesions in bone usually spare the epiphysis before puberty, but often involve the epiphyseal area after maturity and can progress during adult life [3]. Unless cystic [6, 10] or malignant change [7, 10, 11] occurs, fibrous dysplasia usually remains contained within bone.

Intraosseous lipoma within the femoral head. A case report.

Intraosseous lipoma occurring within the femoral head seems not to have been previously reported. Symptoms associated with the tumor included slowly increasing pain and a cystic lesion shown on roentgenograms. Management was by total hip arthroplasty. Pathologic examination of the specimen showed that the tumor was composed almost entirely of mature adipose tissue in keeping with a diagnosis of Stage 1 intraosseous lipoma. A sclerotic border and osteoid seams were noted, two features that seem not to have been previously reported in early lesions. Recent papers suggest intraosseous lipomas are more common than previously thought, and the femur now accounts for 25% of reported cases.