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June 1, 1994

Orthopedics and Sports Medicine

Author Affiliations

Boston University Medical School, Boston, Mass

JAMA. 1994;271(21):1697-1698. doi:10.1001/jama.1994.03510450069038

In the literature of the past year, we continued to see the preoccupation of the orthopedic world with total joint arthroplasty and, in particular, with the problem of particulate debris and eventual loosening of prostheses. Maloney et al1 studied 14 patients with severe pelvic osteolysis after having had an acetabular replacement without cement. The osteolysis appeared from 53 to 84 months after the index operation and, although all patients initially had good function, by the time the article was written, nine patients required re-operation. Particulate debris, primarily polyethylene, was present in all hips.

The treatment of primary bone tumors seems to be becoming the province of a small number of specially trained orthopedic surgeons, a practice that seems logical because other orthopedic surgeons may not keep abreast of the remarkable advances being made in the treatment of primary bone tumors and of the newest diagnostic tests. During the past

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