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

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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

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    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. (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