Infected Pseudotumor in Total Hip Arthroplasty with Metal-on-Metal Friction Couple
Abstract
Total hip arthroplasty (THA) is the main treatment for advanced hip osteoarthritis and its complications include dislocation, infection, aseptic loosening and, to a lesser extent, adverse reactions to metal. Pseudotumor is a rare complication of THA with a metal-on-metal friction couple; its diagnosis and treatment are extremely important to reduce morbidity and mortality. We present the case of a 63-year-old male patient with a 13-year history of THA with a metal-on-metal friction couple who, at the time of consultation, presented a large palpable mass in the right gluteus and paresthesias in the homolateral sciatic nerve. The diagnosis of an infected pseudotumor was reached and treated with hip revision and antibiotic therapy.Downloads
References
Learmonth ID, Young C, Rorabeck C. The operation of the century: Total hip replacement. Lancet 2007;370:1508‑19. https://doi.org/10.1016/S0140-6736(07)60457-7
Fabi D, Levine B, Paprosky W, Della Valle C, Sporer S, Klein G, et al. Metal‐on‐metal total hip arthroplasty: Causes and high incidence of early failure. Orthopedics 2012;35:e1009‐16. https://doi.org/10.3928/01477447-20120621-12
Bosker BH, Ettema HB, Boomsma MF, Kollen BJ, Maas M, Verheyen CC. High incidence of pseudotumour
formation after large‑diameter metal‑on‑metal total hip replacement: A prospective cohort study. J Bone Joint Surg Br 2012;94:755‑61. https://doi.org/10.1302/0301-620X.94B6.28373
van Lingen CP, Ettema HB, Bosker BH, Verheyen CCPM. Ten-year results of a prospective cohort of large-head
metal-on-metal total hip arthroplasty: a concise follow-up of a previous report. Bone Jt Open 2022;3(1):61-7.
https://doi.org/10.1302/2633-1462.31.BJO-2021-0159.R1
Van Der Straeten C, Grammatopoulos G, Gill HS, Calistri A, Campbell P, De Smet KA. The 2012 Otto Aufranc
Award: The interpretation of metal ion levels in unilateral and bilateral hip resurfacing. Clin Orthop Relat Res
;471:377‐85. https://doi.org/10.1007/s11999-012-2526-x
Wiley KF, Ding K, Stoner JA, Teague DC, Yousuf KM. Incidence of pseudotumor and acute lymphocytic vasculitis associated lesion (ALVAL) reactions in metal‐on‐metal hip articulations: A meta‐analysis. J Arthroplasty
;28:1238‐45. https://doi.org/10.1016/j.arth.2013.03.027
Griffiths HJ, Burke J, Bonfiglio TA. Granulomatous pseudotumors in total joint replacement. Skeletal Radiol
;16(2):146-52. https://doi.org/10.1007/BF00367764
Davda K, Lali FV, Sampson B, Skinner JA, Hart AJ. An analysis of metal ion levels in the joint fluid of symptomatic patients with metal-on-metal hip replacements. J Bone Joint Surg Br 2011;93(6):738-45.
https://doi.org/10.1302/0301-620X.93B6.25804
Kwon YM, Ostlere SJ, McLardy-Smith P, Athanasou NA, Gill HS, Murray DW. “Asymptomatic” pseudotumors
after metal-on-metal hip resurfacing arthroplasty: prevalence and metal ion study. J Arthroplasty 2011;26(4):511-8. https://doi.org/10.1016/j.arth.2010.05.030
Almousa SA, Greidanus NV, Masri BA, Duncan CP, Garbuz DS. The natural history of inflammatory pseudotumors in asymptomatic patients after metal-on-metal hip arthroplasty. Clin Orthop Relat Res 2013;471(12):3814-21. https://doi.org/10.1007/s11999-013-2944-4
Grammatopoulos G, Pandit H, Kwon YM, Gundle R, McLardy-Smith P, Beard DJ, et al. Hip resurfacings revised
for inflammatory pseudotumour have a poor outcome. J Bone Joint Surg Br 2009;91(8):1019-24. https://doi.org/10.1302/0301-620X.91B8.22562. Erratum in: Bone Joint J 2015;97-B(7):1012.
https://doi.org/10.1302/0301-620X.97B7.36529b
Medicines and Healthcare Products Regulatory Agency. Medical device alert. All metal-on-metal (MoM) hip
replacements: updates advice for follow-up of patients; 2017. Disponible en:
https://assets.publishing.service.gov.uk/media/5954ca1ded915d0baa00009b/MDA-2017-018_Final.pdf
U.S. Food and Drug Administration. Metal-on-metal hip implants - concerns about metal-on-metal hip implants; 2019. Disponible en: https://www.fda.gov/medical-devices/metal-metal-hip-implants/concerns-about-metal-metal-hip-implants
Metal-on-metal hip implants - Information for Orthopaedic Surgeons regarding patient management following surgery - For health professionals; 2012. Disponible en: http://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2012/15835a-eng.php
Chana R, Esposito C, Campbell PA, Walter WK, Walter WL. Mixing and matching causing taper wear: Corrosion
associated with pseudotumor formation. J Bone Joint Surg Br 2012;94:281‑6. https://doi.org/10.1302/0301-620X.94B2. 27247
Davis DL, Morrison JJ. Hip arthroplasty pseudotumors: Pathogenesis, imaging, and clinical decision making. J Clin Imaging Sci 2016;6:17. https://doi.org/10.4103/2156-7514.181493
Gallart X, Marín O. Información y asesoramiento para cirujanos ortopédicos: árbol de decisiones ante un paciente portador de prótesis con par de fricción metal-metal. Revista Española de Cirugía Ortopédica y Traumatología 2011;55(1):67-9. https://doi.org/10.1016/j.recot.2010.12.007
Keegan G, Learmonth I, Case C. Orthopaedic metals and their potential toxicity in the arthroplasty patient: A review of current knowledge and future strategies. J Bone Joint Surg Br 2007;89(5):567-73. https://doi.org/10.1302/0301-620X.89B5.1890
Watters TS, Eward WC, Hallows RK, Dodd LG, Wellman SS, Bolognesi MP. Pseudotumor with superimposed
periprosthetic infection following metal-on-metal total hip arthroplasty: a case report. J Bone Joint Surg Am
;92(7):1666-9. https://doi.org/10.2106/JBJS.I.01208
Artiaco S, Ferrero A, Boggio F, Colzani G. Pseudotumor of the hip due to fungal prosthetic joint infection. Case
Rep Orthop 2013;2013:502728. https://doi.org/10.1155/2013/502728
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
