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Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica
Total hip arthroplasty (THA) is the preferred treatment for patients with hip joint disorders refractory to conservative management. While original implants were designed to articulate a metallic femoral head onto a polyethylene liner, the popularity of “metal-on-metal” (MoM) hip implants surged in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657017/ https://www.ncbi.nlm.nih.gov/pubmed/38022109 http://dx.doi.org/10.7759/cureus.47322 |
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author | Ahmed, Adham Grabie, Yisroel Loeffler, Jeffrey Buchen, Yosef Acharya, Sudeep |
author_facet | Ahmed, Adham Grabie, Yisroel Loeffler, Jeffrey Buchen, Yosef Acharya, Sudeep |
author_sort | Ahmed, Adham |
collection | PubMed |
description | Total hip arthroplasty (THA) is the preferred treatment for patients with hip joint disorders refractory to conservative management. While original implants were designed to articulate a metallic femoral head onto a polyethylene liner, the popularity of “metal-on-metal” (MoM) hip implants surged in the early 21st century due to their perceived superior long-term durability and lower revision rates. However, subsequent follow-up studies showed high failure rates due to inflammatory responses to periprosthetic metallic debris leading to lymphocytic proliferation, soft tissue necrosis or fibrosis, systemic metal toxicity, and/or the development of cystic pseudotumors. Although these discoveries resulted in a significant decrease in MoM THA and revision procedures, the majority of MoM hip implants persist in the adult population. In this case report and review, we report the presentation, diagnostic work-up, and management of an 84-year-old status-post MoM THA who presented with unilateral leg tenderness and poor ambulation secondary to pseudotumor-induced sciatica. |
format | Online Article Text |
id | pubmed-10657017 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-106570172023-10-19 Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica Ahmed, Adham Grabie, Yisroel Loeffler, Jeffrey Buchen, Yosef Acharya, Sudeep Cureus Pathology Total hip arthroplasty (THA) is the preferred treatment for patients with hip joint disorders refractory to conservative management. While original implants were designed to articulate a metallic femoral head onto a polyethylene liner, the popularity of “metal-on-metal” (MoM) hip implants surged in the early 21st century due to their perceived superior long-term durability and lower revision rates. However, subsequent follow-up studies showed high failure rates due to inflammatory responses to periprosthetic metallic debris leading to lymphocytic proliferation, soft tissue necrosis or fibrosis, systemic metal toxicity, and/or the development of cystic pseudotumors. Although these discoveries resulted in a significant decrease in MoM THA and revision procedures, the majority of MoM hip implants persist in the adult population. In this case report and review, we report the presentation, diagnostic work-up, and management of an 84-year-old status-post MoM THA who presented with unilateral leg tenderness and poor ambulation secondary to pseudotumor-induced sciatica. Cureus 2023-10-19 /pmc/articles/PMC10657017/ /pubmed/38022109 http://dx.doi.org/10.7759/cureus.47322 Text en Copyright © 2023, Ahmed et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pathology Ahmed, Adham Grabie, Yisroel Loeffler, Jeffrey Buchen, Yosef Acharya, Sudeep Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title | Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title_full | Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title_fullStr | Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title_full_unstemmed | Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title_short | Reactive Peri-Arthroplasty Pseudotumors: A Rare Cause of Hip Pain and Iatrogenic Sciatica |
title_sort | reactive peri-arthroplasty pseudotumors: a rare cause of hip pain and iatrogenic sciatica |
topic | Pathology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657017/ https://www.ncbi.nlm.nih.gov/pubmed/38022109 http://dx.doi.org/10.7759/cureus.47322 |
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