This case report details the presentation, imaging results, and operative findings of a pseudotumor associated with a press-fit metal-on-polyethylene total hip arthroplasty (THA). An 80-year-old man presented approximately 7 years after undergoing THA with worsening right groin and lateral hip pain with an associated proximal thigh mass. Physical examination demonstrated a tender, large anterolateral thigh mass that was also evident on metal artifact reduction sequence magnetic resonance imaging.An exploratory operative procedure revealed extensive tissue necrosis involving nearly the entire hip capsule, short external rotators, and tendinous portion of the gluteus medius muscle. In addition, marked surface corrosion was discovered about the taper at the head-neck junction of the prosthetic femoral component and the trunnion within the femoral head. The press-fit THA components were solidly fixed. The metallic head was replaced with a ceramic component, and the polyethylene liner was exchanged. The patient had complete resolution of his preoperative symptoms but had persistent problems with dislocations.Although reports of pseudotumor and local soft tissue reactions associated with metal-on-metal THAs have become increasingly ubiquitous in the literature, similar reports involving metal-on-polyethylene THA implants are less common.

The proposed FNSI MRI classification system provides a robust framework for patient management optimization by permitting differentiation between operative and nonoperative candidates, by allowing accurate prediction of RTD time, and by estimating the risk of not completing BT and requiring medical discharge from the military.

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Older patients with higher ASA class have longer LOHS and increased discharges to a SNF. Patients whose surgery was performed after instituting a "pathway" program and those with higher BMI had a decreased LOHS.