The imaging spectrum of peri-articular inflammatory masses following metal-on-metal hip resurfacing
- 296 Downloads
Resurfacing metal-on-metal hip arthroplasty is increasing in popularity, especially in younger patients. To date, studies indicate that the procedure is associated with a good outcome in the medium-term. Formation of a peri-articuar mass is a rarely reported complication. In this study we analyse the imaging findings in patients with resurfacing implants presenting to our institution with peri-articular masses identified on cross sectional imaging.
Materials and methods
All patients with documented peri-articular masses following resurfacing arthroplasty were included. The available imaging related to the masses was reviewed and the findings documented along with the patient’s demographics.
There were 10 patients (13 joints). All patients were female. Patients presented with periprosthetic anterior or posterolateral solid and cystic masses. The anterior masses involved psoas muscle and were predominately solid. The posterolateral masses were predominately cystic. In the three cases with bilateral arthroplasties, masses were detected in both hips. Histology in six cases showed features compatible with a type IV hypersensitivity reaction.
The preponderance of females, the bilateral nature of the masses and the histological features suggest that peri-articular masses following resurfacing arthroplasty is due to the metal hypersensitivity.
KeywordsResurfacing hip arthroplasty Mass Hypersensitivity reaction Solid Cystic
- 6.Visuri T, Pukkala E, Paavolainen P, Pulkkinen P, Riska EB. Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty. Clin Orthop Relat Res 1996; Aug [329 Suppl]: S280–289.Google Scholar
- 10.Schuh A, Zeiler G, Holzwarth U, Aigner T. Malignant fibrous histiocytoma at the site of a total hip arthroplasty. Clin Orthop Relat Res 2004; Aug: 218–222.Google Scholar
- 13.Holgate SJ, Hamblin TJ. The hypersensitivity reaction. In: McGee JO’D, Isaacson PG, Wright NA, Dick HM, Slack MPE, eds. Oxford textbook of pathology. Oxford University Press; 1992: 275–279.Google Scholar
- 15.Schnuch A, Geier J, Uter W, et al. National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK). Contact Dermatitis 1997; 37: 200–209. Nov.PubMedCrossRefGoogle Scholar