A patient with rheumatoid arthritis operated on with insertion of an uncemented ceramic-on-ceramic Mittelmeier total hip developed an extensive, rapidly evolving osteolysis around the prosthetic stem, which in turn fractured spontaneously after 5 years. Aggressive bone resorption cannot be prevented by exclusion of polyethylene and bone cement from hip arthroplasty.
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Borsén et al. (1991) studied this question.
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