Aggressive granulomatosis (particle disease) left total hip prosthesis

Discussion:

The lytic mass is throught to represent a foreign body granulomatous reaction containing histiocytes induced by the prosthesis causing bone expansion and erosion.  The key to this case is the eccentricity of the femoral head in the acetabular cup indicating excessive liner wear.  This liner is made of polyethylene and it is believed that small fragments or particles of the liner break off and enter the joint space, causing a foreign body reaction.  It is not thought to be an infective process.

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