Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar 1;7(1):33-38.
doi: 10.1089/biores.2017.0035. eCollection 2018.

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

Caleb W Grote  1 , Paul C Cowan  2 , David W Anderson  3 , Kimberly J Templeton  1
Affiliations
Review

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

Caleb W Grote et al. Biores Open Access. .

Abstract

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.

Keywords: metal-on-metal total hip arthroplasty; pseudotumor; unilateral leg edema; women's health.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
AP pelvis radiographs show right metal-on-polyethylene THA and left metal-on-metal THA. Components appear in appropriate positions without obvious signs of loosening. AP, anterior-posterior; THA, total hip arthroplasty.
<b>FIG. 2.</b>
FIG. 2.
Axial cut from CT scan showing large fluid collection (arrow) measuring 5.5 × 6.0 × 10.4 cm that is originating from THA and displacing external iliac vasculature. CT, computed tomography.
<b>FIG. 3.</b>
FIG. 3.
Venogram of external iliac vein performed intraoperatively by vascular surgery team showed ∼70% compression in area of pseudotumor (arrow).
<b>FIG. 4.</b>
FIG. 4.
Revision left THA to metal-on-polyethylene construct.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hawker GA, Wright JG, Coyte PC, et al. . Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med 2000;342:1016–1022 - PubMed
    1. Maradit Kremers H, Larson DR, Crowson CS, et al. . Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am 2015;97:1386–1397 - PMC - PubMed
    1. Kurtz S, Ong K, Lau E, et al. . Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007;89:780–785 - PubMed
    1. Kumar N, Arora GN, Datta B. Bearing surfaces in hip replacement—evolution and likely future. Med J Armed Forces India 2014;70:371–376 - PMC - PubMed
    1. Bolognesi MP, Ledford CK. Metal-on-metal total hip arthroplasty: patient evaluation and treatment. J Am Acad Orthop Surg 2015;23:724–731 - PubMed

LinkOut - more resources