High Grade Osteosarcoma at the Site of a Ceramic on Cross-Linked Polyethylene Cementless Hip Replacement: A Case Report and Review of the Literature

The following case report describes a 50-year-old male with a history of post-traumatic arthritis of the right hip after a previous open reduction of a traumatic hip dislocation as a young adult. He underwent an uncomplicated ceramic on highly cross-linked polyethylene primary total hip arthroplasty (THA), with unremarkable intra-operative pathology at that time. Three years postoperatively, the patient developed acute onset of hip and groin pain and associated radiographic findings which proved to be related to a high-grade osteosarcoma within the soft tissue juxtaposed to the ceramic on highly cross-linked polyethylene THA. While metal-associated primary bone sarcomas have been previously reported, we are unaware of any prior description of an osteosarcoma in the setting of a ceramic on highly cross-linked polyethylene articulation. This current report represents the first case of a primary osteosarcoma associated with this type of hip arthroplasty articulation.