Extra-articular inflammatory pseudotumor after well-fixed metal-polyethylene total hip arthroplasty
10.3760/cma.j.issn.0253-2352.2012.06.003
- VernacularTitle:全髋关节置换术后髋周炎性假瘤的诊断与治疗
- Author:
Pengde KANG
;
Fuxing PEI
;
Bin SHEN
;
Zongke ZHOU
;
Jing YANG
- Publication Type:Journal Article
- Keywords:
Arthroplasty,replacement,hip;
Polyethylene;
Granuloma,plasma cell
- From:
Chinese Journal of Orthopaedics
2012;32(6):526-532
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the diagnosis and treatment of the extra-articular inflammatory pseudotumor after well-fixed metal-polyethylene total hip arthroplasty (THA).Methods From March 2006 to June 2011,7 patients (7 hips) who presented with a progressive pain and/or swelling,discomfort in groin or upper thigh after metal-polyethylene THA were admitted to our hospital.There were 2 males and 5 females,with an average age of 48.8 years (range,32-65 years).All 7 patients were identified with a periprosthetic osteolysis at the acetabular and/or femoral components and a mass in the iliac fossa or the thigh; however,the components were all well-fixed.The masses were confirmed by CT scanning and/or ultrasound examination.The revision procedures were done through ilioinguinal approach and posterior-lateral approach,and the pseudotumors were excised and osteolytic lesions were debrided and packed tightly with morselized cancellous allograft.The liner and femoral head were also exchanged at the same time.Clinical and radiographic outcomes of revision THA were evaluated.Results All 7 patients were followed up for 3-42 months (average,30 months).At final follow-up,all hips were functioning well and the average Harris hip score was 92.4.All acetabular components remained radiographically well-fixed.All cavitary defects had complete radiographic incorporation of the bone grafts.There were no new pseudotumor or osteolytic lesions identified,and no revision of the components.Conclusion The presence of abdominal or pelvic pseudotumor in patient with a THA may be associated with polyethylene wear.Once the extra-articular pseudotumor and the periprosthetic osteolysis are identified,the surgical treatment,including pseudotumor excise,osteolytic lesion debride and bone defect grafting and bearing surface exchange,can achieve retention of well-fixed components.
