Diagnosis of adverse local tissue reactions following metal-on-metal hip arthroplasty

  • Brian P. Chalmers
  • Kevin I. Perry
  • Michael J. Taunton
  • Tad M. Mabry
  • Matthew P. AbdelEmail author
Hip: Metal-on-Metal (J Cooper, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hip: Metal-on-Metal


Metal-on-metal (MOM) bearing surfaces in hip arthroplasty have distinct advantages that led to the increase in popularity in North America in the early 2000s. However, with their increased use, concerns such as local cytotoxicity and hypersensitivity reactions leading to soft tissue damage and cystic mass formation (known collectively as adverse local tissue reactions (ALTR)) became apparent. The clinical presentation of ALTR is highly variable. The diagnosis of ALTR in MOM articulations in hip arthroplasty can be challenging and a combination of clinical presentation, physical examination, implant track record, component positioning, serum metal ion levels, cross-sectional imaging, histopathologic analysis, and consideration of alternative diagnoses are essential.


Total hip arthroplasty (THA) Metal-on-metal (MOM) Adverse local tissue reactions (ALTRs) Pseudotumor Aseptic lymphocytic vasculitic-associated lesion (ALVAL) 


Compliance with ethical standards

Conflict of interest

Brian P. Chalmers, Kevin I. Perry, Tad M. Mabry, and Matthew P. Abdel declare that they have no conflict of interest.

Michael J. Taunton reports personal fees from DJO Global, outside of the submitted work.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Brian P. Chalmers
    • 1
  • Kevin I. Perry
    • 1
  • Michael J. Taunton
    • 1
  • Tad M. Mabry
    • 1
  • Matthew P. Abdel
    • 1
    Email author
  1. 1.Department of Orthopedic SurgeryMayo ClinicRochesterUSA

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