Failed hip prostheses in hemodialysis patients: Amyloid deposition at the bone-implant interface in 4 cases

4 hemodialysis patients with failed bipolar hip prostheses underwent 6 revision arthroplasties. Their average age was 55 years, the average duration of hemodialysis was 14 years and the average interval from the primary arthroplasty to revision was 7 years. The interface membranes revealed amyloid deposits in all specimens. There were few polyethylene wear particles, and cement debris or foreign body reactions were rare. It appears that amyloid may cause osteolysis and early prosthetic loosening.