Denosumab after total hip arthroplasty

which studied the effect of denosumab on osteolytic lesions seen at the time of revision total hip arthroplasty surgery. In their phase 2, randomised, placebo-controlled, double-blind, proof of concept study, Mahatma and colleagues found that there was an 83% decrease in number of osteoclasts in the osteolytic membrane–bone interface in the denosumab group compared with the placebo group. Since the study showed a beneficial role of denosumab on osteolysis after total hip arthroplasty, the authors recommended future studies on this, with clinical outcomes as endpoints in the early stages of osteolysis. This trial is a landmark study that ignites hope for effective medical management for this disabling condition, which hitherto required revision surgery. However, certain concerns need to be addressed for the benefit of the readers.