Total hip replacement (THR) is a common procedure in orthopedic surgery. Due to the fact that many patients have increased life expectancy with their initial THR, the need for revision surgery has increased. One of the most common reasons for revision is osteolysis as a result of wear debris. There are two major types of osteolysis: linear (focal) or cavitary, which are more prevalent in cemented and cementless THRs, respectively. Dependent upon the size and shape of the lesions, viable treatment alternatives have been developed and are discussed in this article. Many issues remain to be resolved to further optimize treatment of osteolysis during revision hip surgery. It is the hope of the authors to summarize the current data on this subject to encourage further refinement in the management of this challenging problem with the overall goal of improving patient outcome.
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