Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty. (1st October 2017)

• Record Type: Journal Article
• Authors: Tamaki, Yasuaki; Goto, Tomohiro; Tsutsui, Takahiko; Takasago, Tomoya; Wada, Keizo; Sairyo, Koichi
• Other Names: Yasuda Taketoshi Academic Editor.
• Is Part Of: Case reports in orthopedics. Volume 2017(2017)
• Publication Date: 2017-10-01
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedics; Periodicals; Electronic journals; Periodicals; 616.7
• DOI: 10.1155/2017/2594902
• Languages: English
• ISSNs: 2090-6749

Abstract

Abstract : Here we present a case of pseudotumor following total hip arthroplasty (THA) that resulted in a circulatory disturbance caused by compression of the femoral vasculature. A 63-year-old man presented with pain, swelling, and redness of the left leg 5 years after primary metal-on-metal THA using the AML-Plus stem, Pinnacle® acetabular cup, and 36 mm diameter Ultamet™ metal head system (DePuy Orthopaedics, Warsaw, IN). Enhanced computed tomography and magnetic resonance imaging revealed a large cystic lesion extending from the left hip anteriorly to the intrapelvic region and compressing the left femoral vessels. Percutaneous puncture of the lesion yielded a dark red aspirate and the patient was diagnosed to have a pseudotumor causing compression of the femoral vessels. We performed revision surgery to replace the metal head and metal liner with a smaller ceramic head and polyethylene liner without removal of the stem. Corrosion of the head-neck junction was identified intraoperatively with no obvious wear on the bearing surfaces. The left leg swelling and redness improved immediately postoperatively. A large pseudotumor should be kept in mind as a cause of vascular compression with unilateral leg edema in a patient who has undergone metal-on-metal THA.