Common Femoral Vein Thrombosis Caused By a Metal-On-Metal Hip Arthroplasty–Related Pseudotumor

Parfitt, D; Wood, Simon; Chick, Christopher; Lewis, P.; Rashid, Majid; Evans, Aled R.

doi:10.1016/j.arth.2012.01.024

Cited by 15 publications

(20 citation statements)

References 7 publications

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“…Instability, weakness, a palpable mass, hip discomfort without flank pain, and a localized rash were also detected. There have been several reports of patients in whom the femoral vessels became compressed by a large pseudotumor and whose presentation was similar to that of our patient [ 12 , 13 ]. Basically, progression of osteolysis or a pseudotumor associated with a hip prosthesis tends to extend around the iliopsoas tendon or external rotator muscles because of the pressure gradient in the effective joint space; that is, a pseudocapsule generated after THA has some weak areas where herniation or extrusion into the joint space is more likely to occur [ 14 ].…”

Section: Discussionsupporting

confidence: 79%

Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

Tamaki

Goto

Tsutsui

et al. 2017

Case Reports in Orthopedics

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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.

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Section: Discussionsupporting

confidence: 79%

Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

Tamaki

Goto

Tsutsui

et al. 2017

Case Reports in Orthopedics

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“…Parfitt et al in 2012 published the first report of unilateral leg swelling related to a pseudotumor from an MoM THA; this is also the only case report published that described a male patient. 27 As with the patients described by Memon et al 29 and Abdel-Hamid et al, 31 this patient was found to have a DVT and was treated with anticoagulation and inferior vena cava filter before surgical intervention for the pseudotumor. In addition, Abdel-Hamid et al reported involving vascular surgery in the treatment paradigm.…”

Section: Discussionmentioning

confidence: 54%

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

Grote

Cowan²,

Anderson

et al. 2018

BioResearch Open Access

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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 vascular surgeon, the patient underwent revision THA and excision of her pseudotumor. She had complete resolution of her swelling at 4 years after surgery. Review of all available case reports for this rare complication revealed that almost all patients were female. All patients underwent revision THA, with resolution of their symptoms. Literature review demonstrates that women are disproportionally affected by complications associated with MoM THA. We recommend close monitoring of patients with MoM THA, particularly women, for development of adverse metal reactions.

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“…Compression of intrapelvic and thigh veins are associated with the development of deep venous thrombosis. [ 72 73 ] External compression of venous structures also has been described which produce lower extremity edema and mimic the clinical symptoms and signs of deep venous thrombosis. [ 59 74 75 ] Femoral and sciatic nerve palsy are known to occur following compression or encasement by an adjacent pseudotumor.…”

Section: Pseudotumor-related Complicationsmentioning

confidence: 99%

Hip Arthroplasty Pseudotumors: Pathogenesis, Imaging, and Clinical Decision Making

Davis

Morrison

2016

Journal of Clinical Imaging Science

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Pseudotumors are a complication of hip arthroplasty. The goal of this article is to review the clinical presentation, pathogenesis, histology, and the role of diagnostic imaging in clinical decision making for treatment, and surveillance of pseudotumors. We will discuss the multimodal imaging appearances, differential diagnosis, associated complications, treatment, and prognosis of pseudotumors, as an aid to the assessment of orthopedic prostheses at the hip.

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Common Femoral Vein Thrombosis Caused By a Metal-On-Metal Hip Arthroplasty–Related Pseudotumor

Cited by 15 publications

References 7 publications

Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty

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

Hip Arthroplasty Pseudotumors: Pathogenesis, Imaging, and Clinical Decision Making

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