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Evaluation of osteolysis after total hip arthroplasty remains a challenge. It may reflect a myriad of problems: from wear-debris induced lesions to infection, metabolic bone disease or even malignant infiltration. We present the clinical, radiographic and pathological features of a 64-year-old woman in whom loosening and failure of total hip arthroplasty occurred secondary to a periacetabular metastasis from a previously undiagnosed lung carcinoma.
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