Noninflammatory pseudotumor simulating venous thrombosis after metal-on-metal hip resurfacing.

نویسندگان

  • Werner Maurer-Ertl
  • Joerg Friesenbichler
  • Bernadette Liegl-Atzwanger
  • Gerda Kuerzl
  • Reinhard Windhager
  • Andreas Leithner
چکیده

Metal-on-metal hip resurfacing has become a widespread procedure, especially in young, physically active patients. Pseudotumor is a new complication that can occur after hip resurfacing and metal-on-metal total hip arthroplasty (THA). This article presents a case of a 37-year-old woman who underwent metal-on-metal resurfacing of the left hip for symptomatic osteoarthritis. Twelve months following implantation, the patient reported painless swelling of the left lower leg. There was no clinical evidence of a deep venous thrombosis. Ultrasound and computed tomography showed a solid cystic lesion in the iliopsoas muscle, which communicated with the hip joint and compressed the external iliac vein. As a consequence, the cystic lesion was resected marginally. A few months later, the patient reported some discomfort in the groin and symptoms of instability, metallic clicking, and a restricted range of motion. Clinical and radiological examination revealed normal findings. Determining the serum concentration of cobalt and chromium revealed high increased levels of these metal ions. Ten months following excision of the pseudotumor, the patient reported recurrent swelling of the left lower leg. Computed tomography of the affected area showed a lobulated cystic formation; therefore, a relapse was suspected. At the second revision, the mass was excised and the implant was revised to a conventional ceramic-on-ceramic THA. At 30-month follow-up, the patient was doing well and there were no signs of local recurrence. Additionally, the metal ion levels of cobalt and chromium in the blood had significantly decreased.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Combined Vascular and Orthopaedic Approach for a Pseudotumor Causing Deep Vein Thrombosis after Metal-on-Metal Hip Resurfacing Arthroplasty

Introduction. Metal-on-metal (MoM) hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to cause deep venous thrombosis (DVT). Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal hip resurfacing 6 years ago presented...

متن کامل

Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

Metal-on-metal (MoM) total hip arthroplasty (THA) can be associated with adverse metal reactions, including pseudotumors. This case report describes a 58-year-old female with an MoM THA-related pseudotumor that caused unilateral leg edema from compression of her external iliac vein. After thorough preoperative workup to rule out infection and deep vein thrombosis and consultation with a vascula...

متن کامل

Groin pain after metal-on-metal hip resurfacing prosthesis

Total hip replacement continues to be a widely successful operation, but persistent groin pain following a metal-on-metal hip resurfacing remains a problem for some patients. The concern regarding the safety and efficacy of metal-on-metal total hip replacements has been rising. We present the case of a 47-year-old man with groin pain after metal-on-metal hip resurfacing. We observed high metal ...

متن کامل

Mortality rates at 10 years after metal-on-metal hip resurfacing compared with total hip replacement in England: retrospective cohort analysis of hospital episode statistics

OBJECTIVES To compare 10 year mortality rates among patients undergoing metal-on-metal hip resurfacing and total hip replacement in England. DESIGN Retrospective cohort study. SETTING English hospital episode statistics database linked to mortality records from the Office for National Statistics. POPULATION All adults who underwent primary elective hip replacement for osteoarthritis from ...

متن کامل

Ion Release from Metal-on-metal Hip Resurfacing Implants Does Not Differ from Standard Metal-on-metal Total Hip Replacement

STANDARD METAL-ON-METAL TOTAL HIP REPLACEMENT *Moroni A, **Savarino L, *Cadossi M, **Greco M, **Baldini N, *Giannini S * Rizzoli Orthopaedic Institute, Bologna, Italy **Laboratory for Pathophysiology of Orthopaedic Implants, Rizzoli Orthopaedic Institute, Bologna, Italy [email protected] INTRODUCTION Modern metal-on-metal (MOM) hip resurfacing has been introduced as a less invasive method of join...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Orthopedics

دوره 34 10  شماره 

صفحات  -

تاریخ انتشار 2011