Inflammatory Pseudotumor Causing Deep Vein Thrombosis After Metal-On-Metal Hip Resurfacing Arthroplasty

Memon, Adeel R.; Galbraith, John G.; Harty, James; Gul, Rehan

doi:10.1016/j.arth.2012.02.014

Cited by 18 publications

(15 citation statements)

References 18 publications

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“…Parfitt et al in 2012 published the first report of unilateral leg swelling related to a pseudotumor from an MoM THA; this is also the only case report published that described a male patient. 27 As with the patients described by Memon et al 29 and Abdel-Hamid et al, 31 this patient was found to have a DVT and was treated with anticoagulation and inferior vena cava filter before surgical intervention for the pseudotumor. In addition, Abdel-Hamid et al reported involving vascular surgery in the treatment paradigm.…”

Section: Discussionmentioning

confidence: 52%

Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

Grote

Cowan²,

Anderson

et al. 2018

BioResearch Open Access

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Metal-on-metal (MoM) total hip arthroplasty (THA) can be associated with adverse metal reactions, including pseudotumors. This case report describes a 58-year-old female with an MoM THA-related pseudotumor that caused unilateral leg edema from compression of her external iliac vein. After thorough preoperative workup to rule out infection and deep vein thrombosis and consultation with a vascular surgeon, the patient underwent revision THA and excision of her pseudotumor. She had complete resolution of her swelling at 4 years after surgery. Review of all available case reports for this rare complication revealed that almost all patients were female. All patients underwent revision THA, with resolution of their symptoms. Literature review demonstrates that women are disproportionally affected by complications associated with MoM THA. We recommend close monitoring of patients with MoM THA, particularly women, for development of adverse metal reactions.

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Section: Discussionmentioning

confidence: 52%

Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

Grote

Cowan²,

Anderson

et al. 2018

BioResearch Open Access

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“…In these cases, displacement of hardware caused external compression of iliac veins, resulting in acute DVT. 12,[14][15][16][17][18] The DVT resolved following decompression of the vein in all seven cases. Casts and hardware used for the treatment of scoliosis were implicated in four cases.…”

Section: Discussionmentioning

confidence: 99%

Surgical hardware-related iatrogenic venous compression syndrome

et al. 2014

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Deep vein thrombosis related to immobilization is a common and extensively studied disorder, particularly in hospitalized patients. However, the phenomenon of iatrogenic venous compression (IAVC) and related deep venous thrombosis (DVT) is under-recognized and under-reported. In the absence of relieving the compressive pathology, the recanalization rates are expected to be very low - thereby putting patients at a significant risk for the development of post-thrombotic syndrome (PTS). In this report, we describe two cases of DVT related to IAVC, and review similar cases that have been previously reported in the literature. With advancements in catheter-based technology, patients with IAVC (with or without DVT) may now be offered advanced endovascular treatment options such as catheter-directed pharmacomechanical thrombolysis (PMT) and percutaneous venoplasty and/or stenting. Hence, timely recognition and treatment is essential in the prevention of disabling PTS or life-threatening pulmonary embolism.

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“…One case had a revision surgery and excision of the pseudotumor using the same approach [ 11 ]. Another case was deemed to be inoperable and only revision of the implant was done [ 12 ]. The third case had only marginal resection of the cystic lesion but ten months later the patient developed recurrent swelling and underwent revision surgery of the implant [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Combined Vascular and Orthopaedic Approach for a Pseudotumor Causing Deep Vein Thrombosis after Metal-on-Metal Hip Resurfacing Arthroplasty

Abdel-Hamid

Miles

Carrington

et al. 2015

Case Reports in Orthopedics

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Introduction. Metal-on-metal (MoM) hip resurfacings have been associated with a variety of complications resulting from adverse reaction to metal debris. Pseudotumors have rarely been reported to cause deep venous thrombosis (DVT). Study Design. A case report and a review of the literature. Case Presentation. A 75-year-old female who had left metal-on-metal hip resurfacing 6 years ago presented with left groin pain associated with unilateral lower limb edema and swelling. By duplex and MRI studies, our patient had an extensive soft tissue necrosis associated with a large pelvic mass causing extensive DVT of the lower limb secondary to mechanical compression of the left iliac vein. Results. Our case was initially treated for DVT followed by dual surgical approach. The pseudotumor was excised through a separate iliofemoral approach and revision of the hip implant was undertaken through a posterior approach in the same setting. An inferior vena cava (IVC) filter was inserted to minimise the perioperative risks of handling the iliac veins. Conclusion. A combined approach with vascular surgeons is required. Combined resection of the pseudotumor and revision of the metal bearing surfaces is essential, in order to achieve a good surgical outcome in this rare complication.

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Inflammatory Pseudotumor Causing Deep Vein Thrombosis After Metal-On-Metal Hip Resurfacing Arthroplasty

Cited by 18 publications

References 18 publications

Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

Pseudotumor from Metal-on-Metal Total Hip Arthroplasty Causing Unilateral Leg Edema: Case Presentation and Literature Review

Surgical hardware-related iatrogenic venous compression syndrome

Combined Vascular and Orthopaedic Approach for a Pseudotumor Causing Deep Vein Thrombosis after Metal-on-Metal Hip Resurfacing Arthroplasty

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