Periprosthetic osteolysis after total hip replacement: molecular pathology and clinical management.

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Abstract

[Indexed for MEDLINE] 16. Eur Spine J. 2025 Aug;34(8):3365-3375. doi: 10.1007/s00586-025-08926-6. Epub 2025 May 28. Patient outcomes and surgical strategies in revision cervical arthroplasty following M6-C™ disc-related osteolysis. Scott-Young M(1)(2), Nielsen D(3), Riar S(4)(3), Rathbone E(4). Author information: (1)Faculty of Health Science and Medicine, Bond University, 27 Garden Street, Southport, Gold Coast, QLD, 4215, Australia. mscott-young@goldcoastspine.com.au. (2)Gold Coast Spine, Gold Coast, QLD, 4215, Australia. mscott-young@goldcoastspine.com.au. (3)Gold Coast Spine, Gold Coast, QLD, 4215, Australia. (4)Faculty of Health Science and Medicine, Bond University, 27 Garden Street, Southport, Gold Coast, QLD, 4215, Australia. PURPOSE: Periprosthetic osteolysis from the M6-C™ Artificial Cervical Disc (Orthofix, Lewisville, Texas) has become a significant issue, sometimes requiring revision spine surgery (RSS). This study evaluates patient-reported outcome measures (PROMs) and revision strategies for managing device-related wear and osteolysis. METHODS: PROMs, including the Visual Analogue Scale (VAS) for neck/arm pain and the Neck Disability Index (NDI), were analyzed at pre-index surgery (T1), pre-RSS (T2), and final follow-up (T3). Osteolysis severity was graded radiographically. A control group who underwent primary M6-C cervical total disc replacement (CTDR) without RSS was included for comparison. RESULTS: Of 53 patients with M6-C CTDR, 19 (35.9%) required RSS due to osteolysis. Osteolysis grades included Grade 1 (4 patients), Grade 2 (7 patients), Grade 3 (3 patients), and Grade 4 (5 patients). Revision strategies included removal and anterior fusion, requiring vertebrectomy for Grade 4 cases; revisions to a different CTDR prosthesis were reserved for Grades 1-3. The RSS group showed significant VAS neck pain improvement at T3 (mean = 36.2 points, p