It is still unclear whether it is best, when revision surgery is required for replacement of an acetabular component, to treat femoral focal osteolysis with bone-grafting or instead to leave it untreated because the defect is too small and uncontained; the concern is to prevent bone graft from escaping into the hip joint. We hypothesized that progression of osteolysis can halted if the cause of particulate generation is removed and the femoral component is well osseointegrated. We prospectively followed 21 patients (24 hips) who underwent acetabular revision and curetting of proximal femoral osteolysis. These patients were followed for the minimum 3 years (mean, 4.3 years; range, 3–7.4 years).

At the time of the latest follow-up examination, all hips were judged to be stable and to have well-fixed acetabular cups and femoral stems. No hips had significant progression of the osteolytic defect through the follow-up period and none demonstrated any new osteolytic lesion.

Provided that a femoral component is bone ingrown with osseointegration sufficient to provide long-term stability, that the osteolytic defect is in the proximal aspect of the femur, and that the defect is uncontained, simple curettage is an effective alternative to additional bone-grafting.