Unusual presentation of failed metal-on-metal total hip arthroplasty with features of neoplastic process

Abstract Metal-on-metal (MoM) total hip arthroplasty (THA) is associated with increased incidence of failure from metallosis, adverse tissue reactions, and the formation of pseudotumors. This case highlights a 53-year-old female with an enlarging painful thigh mass 12 years status post MoM THA. Radi...

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Bibliographic Details
Published inArthroplasty today Vol. 3; no. 2; pp. 71 - 76
Main Authors Runner, Robert P., MD, Ahearn, Briggs M., MD, Guild, George N., MD
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2017
Elsevier
Subjects
Arthroplasty
Bone loss
Case Report
Metal-on-metal
Orthopedics
Pseudotumor
Trunnionosis
Pseudotumor
Trunnionosis
Arthroplasty
Bone loss
Metal-on-metal
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Summary:Abstract Metal-on-metal (MoM) total hip arthroplasty (THA) is associated with increased incidence of failure from metallosis, adverse tissue reactions, and the formation of pseudotumors. This case highlights a 53-year-old female with an enlarging painful thigh mass 12 years status post MoM THA. Radiographs and advanced imaging revealed an atypical mass with cortical bone destruction and spiculation, concerning for periprosthetic malignancy. Open frozen section biopsy was performed before undergoing revision THA in a single episode of care. This case illustrates that massive pseudotumors can be locally aggressive causing significant femoral bone destruction and may mimic malignancy. It is important that orthopaedic surgeons, radiologists and pathologists understand the relative infrequency of periprosthetic malignancy in MoM THA to mitigate patient concerns, misdiagnosis, and allow for an evidence based discussion when treating massive pseudotumors.
ISSN:2352-3441
2352-3441
DOI:10.1016/j.artd.2016.10.004