Pseudotumours associated with metal-on-metal hip resurfacings

H. Pandit, S. Glyn-Jones, P. McLardy-Smith, R. Gundle, D. Whitwell, C. L. Gibbons, S. Ostlere, N. Athanasou, H. S. Gill, D. W. Murray

Research output: Contribution to journalArticle

757 Citations (Scopus)

Abstract

We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken. All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision. We estimate that approximately 1% of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause.
Original languageEnglish
Pages (from-to)847-851
Number of pages5
JournalJournal of Bone and Joint Surgery - British Volume
Volume90
Issue number7
DOIs
Publication statusPublished - Jul 2008

Fingerprint

Hip
Metals
Poisons
Exanthema
Radiography
Paralysis
Ultrasonography
Hypersensitivity
Necrosis
Incidence

Cite this

Pandit, H., Glyn-Jones, S., McLardy-Smith, P., Gundle, R., Whitwell, D., Gibbons, C. L., ... Murray, D. W. (2008). Pseudotumours associated with metal-on-metal hip resurfacings. Journal of Bone and Joint Surgery - British Volume, 90(7), 847-851. https://doi.org/10.1302/0301-620X.90B7.20213

Pseudotumours associated with metal-on-metal hip resurfacings. / Pandit, H.; Glyn-Jones, S.; McLardy-Smith, P.; Gundle, R.; Whitwell, D.; Gibbons, C. L.; Ostlere, S.; Athanasou, N.; Gill, H. S.; Murray, D. W.

In: Journal of Bone and Joint Surgery - British Volume, Vol. 90, No. 7, 07.2008, p. 847-851.

Research output: Contribution to journalArticle

Pandit, H, Glyn-Jones, S, McLardy-Smith, P, Gundle, R, Whitwell, D, Gibbons, CL, Ostlere, S, Athanasou, N, Gill, HS & Murray, DW 2008, 'Pseudotumours associated with metal-on-metal hip resurfacings', Journal of Bone and Joint Surgery - British Volume, vol. 90, no. 7, pp. 847-851. https://doi.org/10.1302/0301-620X.90B7.20213
Pandit H, Glyn-Jones S, McLardy-Smith P, Gundle R, Whitwell D, Gibbons CL et al. Pseudotumours associated with metal-on-metal hip resurfacings. Journal of Bone and Joint Surgery - British Volume. 2008 Jul;90(7):847-851. https://doi.org/10.1302/0301-620X.90B7.20213
Pandit, H. ; Glyn-Jones, S. ; McLardy-Smith, P. ; Gundle, R. ; Whitwell, D. ; Gibbons, C. L. ; Ostlere, S. ; Athanasou, N. ; Gill, H. S. ; Murray, D. W. / Pseudotumours associated with metal-on-metal hip resurfacings. In: Journal of Bone and Joint Surgery - British Volume. 2008 ; Vol. 90, No. 7. pp. 847-851.
@article{92b0baa280bc4deea7e3108bf11fc039,
title = "Pseudotumours associated with metal-on-metal hip resurfacings",
abstract = "We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken. All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision. We estimate that approximately 1{\%} of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause.",
author = "H. Pandit and S. Glyn-Jones and P. McLardy-Smith and R. Gundle and D. Whitwell and Gibbons, {C. L.} and S. Ostlere and N. Athanasou and Gill, {H. S.} and Murray, {D. W.}",
year = "2008",
month = "7",
doi = "10.1302/0301-620X.90B7.20213",
language = "English",
volume = "90",
pages = "847--851",
journal = "Journal of Bone and Joint Surgery - British Volume",
issn = "0301-620X",
publisher = "British Editorial Society of Bone and Joint Surgery",
number = "7",

}

TY - JOUR

T1 - Pseudotumours associated with metal-on-metal hip resurfacings

AU - Pandit, H.

AU - Glyn-Jones, S.

AU - McLardy-Smith, P.

AU - Gundle, R.

AU - Whitwell, D.

AU - Gibbons, C. L.

AU - Ostlere, S.

AU - Athanasou, N.

AU - Gill, H. S.

AU - Murray, D. W.

PY - 2008/7

Y1 - 2008/7

N2 - We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken. All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision. We estimate that approximately 1% of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause.

AB - We report 17 patients (20 hips) in whom metal-on-metal resurfacing had been performed and who presented with various symptoms and a soft-tissue mass which we termed a pseudotumour. Each patient underwent plain radiography and in some, CT, MRI and ultrasonography were also performed. In addition, histological examination of available samples was undertaken. All the patients were women and their presentation was variable. The most common symptom was discomfort in the region of the hip. Other symptoms included spontaneous dislocation, nerve palsy, a noticeable mass or a rash. The common histological features were extensive necrosis and lymphocytic infiltration. To date, 13 of the 20 hips have required revision to a conventional hip replacement. Two are awaiting revision. We estimate that approximately 1% of patients who have a metal-on-metal resurfacing develop a pseudotumour within five years. The cause is unknown and is probably multifactorial. There may be a toxic reaction to an excess of particulate metal wear debris or a hypersensitivity reaction to a normal amount of metal debris. We are concerned that with time the incidence of these pseudotumours may increase. Further investigation is required to define their cause.

UR - http://www.scopus.com/inward/record.url?scp=47549111326&partnerID=8YFLogxK

UR - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18591590

UR - http://dx.doi.org/10.1302/0301-620X.90B7.20213

U2 - 10.1302/0301-620X.90B7.20213

DO - 10.1302/0301-620X.90B7.20213

M3 - Article

VL - 90

SP - 847

EP - 851

JO - Journal of Bone and Joint Surgery - British Volume

JF - Journal of Bone and Joint Surgery - British Volume

SN - 0301-620X

IS - 7

ER -