Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty
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 AM...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2017/2594902 |
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| author | Yasuaki Tamaki Tomohiro Goto Takahiko Tsutsui Tomoya Takasago Keizo Wada Koichi Sairyo |
| author_facet | Yasuaki Tamaki Tomohiro Goto Takahiko Tsutsui Tomoya Takasago Keizo Wada Koichi Sairyo |
| author_sort | Yasuaki Tamaki |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e8037195e1bc46338c0610111cbef62b |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-e8037195e1bc46338c0610111cbef62b2025-02-03T01:32:06ZengWileyCase Reports in Orthopedics2090-67492090-67572017-01-01201710.1155/2017/25949022594902Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip ArthroplastyYasuaki Tamaki0Tomohiro Goto1Takahiko Tsutsui2Tomoya Takasago3Keizo Wada4Koichi Sairyo5Department of Orthopedics, Takamatsu Red Cross Hospital, 4-1-3 Ban-cho, Takamatsu, Kagawa 760-0017, JapanDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, JapanDepartment of Orthopedics, Takamatsu Red Cross Hospital, 4-1-3 Ban-cho, Takamatsu, Kagawa 760-0017, JapanDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, JapanDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, JapanDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, JapanHere 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.http://dx.doi.org/10.1155/2017/2594902 |
| spellingShingle | Yasuaki Tamaki Tomohiro Goto Takahiko Tsutsui Tomoya Takasago Keizo Wada Koichi Sairyo Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty Case Reports in Orthopedics |
| title | Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty |
| title_full | Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty |
| title_fullStr | Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty |
| title_full_unstemmed | Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty |
| title_short | Compression of the Femoral Vessels by a Pseudotumor after Metal-on-Metal Total Hip Arthroplasty |
| title_sort | compression of the femoral vessels by a pseudotumor after metal on metal total hip arthroplasty |
| url | http://dx.doi.org/10.1155/2017/2594902 |
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