Seromadesis following total hip resurfacing by aspiration and injection of doxycycline

Here, we present an interesting case of seroma following hip resurfacing arthroplasty in a 69-year-old man. During the postoperative recovery, the patient made rapid progress and returned to intense activity within the 6-week period. He subsequently developed further right hip pain and swelling. On further examination and on ultrasound scan, a lateral thigh collection was noted. All inflammatory markers were within normal parameters; clinically, there was no evidence of active infection. On initial aspiration and washout, there was a large sterile haemoserous collection. The patient subsequently underwent further aspiration due to persistent collection. After this a revision procedure was performed in two stages with excision of the seroma cavity superficial to fascia lata. Methicillin-sensitive Staphylococcus aureus was grown on extended cultures which was treated successfully with antibiotics. After the second stage revision to total hip replacement, this cavity then recollected. A further trial of aspiration with injection of 200 mg doxycycline, a known sclerosing agent, was performed. The seroma resolved.