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Updated: Aug 9, 2026
Potentiodynamic Corrosion Testing
Published on: September 4, 2016
Recurrent intrapelvic cyst complicating metal-on-metal cemented total hip arthroplasty
S Madan1, R L Jowett, M I Goodwin
1Orthopaedic Office, Royal Bournemouth and Poole Hospital, Castle Lane East, UK.
Abstract:
Spontaneous intrapelvic masses causing vascular compression raise the suspicion of a neoplasm or infection. We present a patient who developed a recurrent intrapelvic cyst 14 years after a McKee-Farrar total hip arthroplasty which presented as acute onset of lower limb swelling, threatening the vascularity of the limb. This cyst recurred three times, and the patient finally needed revision total hip arthroplasty. The most probable cause of the recurrence was the cement and metal wear debris. Such cysts have been described in the literature, but to the best of our knowledge, this is the only report that describes it complicating a metal-on-metal prosthesis.
Insights
Recurrent intrapelvic cysts can develop after hip replacement surgery, potentially causing limb swelling. Wear debris from metal-on-metal prostheses may be a cause, necessitating revision surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Vascular Surgery
Background:
- Intrapelvic masses can mimic neoplasms or infections, often causing vascular compression.
- Total hip arthroplasty (THA) complications can include mass formation, though intrapelvic cysts are rare.
- Metal-on-metal (MoM) prostheses have specific wear characteristics that may contribute to adverse tissue reactions.
Observation:
- A patient presented with acute lower limb swelling due to an intrapelvic cyst.
- This cyst recurred three times over a period, significantly impacting the patient's vascularity.
- The patient had a history of a McKee-Farrar total hip arthroplasty 14 years prior.
Findings:
- The recurrent intrapelvic cyst was strongly associated with the patient's MoM hip prosthesis.
- Cement and metal wear debris were identified as the most probable cause of cyst formation and recurrence.
- This case represents the first reported instance of such a cyst complicating a MoM prosthesis.
Implications:
- This case highlights a rare but serious complication associated with MoM hip arthroplasty.
- Understanding the role of wear debris is crucial for managing late complications after THA.
- Revision THA may be necessary to address persistent intrapelvic cystic masses related to implant wear.
