Massive Periprosthetic Osteolysis Spreads to the Soft Tissue and Pelvic Region after Primary Total Hip Replacement: A Case Report

INTRODUCTION: Periprosthetic osteolysis (PPOL) is a serious complication after total hip replacement and requires immediate action to prevent further spread to nearby tissues and has the opportunity to restore hip function successfully. We present the case of PPOL of a patient with a challenging course of treatment. CASE REPORT: We report a 75-year-old patient with PPOL that spreads to the soft tissues and pelvic region 14 years after primary total hip arthroplasty. At all stages of treatment, an elevated neutrophil-dominant cell count was detected in the analysis of synovial fluid aspiration of the left hip joint without detection of microbiological culture. Due to severe bone loss and general patient condition, no further surgical treatment was indicated, and there is no clear vision of future actions. CONCLUSION: Management of severe PPOL can be challenging, as there are limited surgical treatment options with a good long-term prognosis. If an osteolytic process is suspected, it should be treated as soon as possible to avoid more severe progression of the complications.