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Pseudo-abscess of the psoas bursa in failed double-cup arthroplasty of the hip

D W Howie1, C M Cain, B L Cornish

  • 1Department of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, South Australia.

The Journal of Bone and Joint Surgery. British Volume
|January 1, 1991
PubMed

Insights

Revision hip arthroplasties can reveal psoas bursae with purulent fluid, often caused by polyethylene wear debris, not infection. This finding impacts understanding of implant failure complications.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Pathology

Background:

  • Resurfacing hip arthroplasty is a common procedure.
  • Implant failure necessitates revision surgery.
  • Psoas bursitis is a potential complication after hip surgery.

Purpose of the Study:

  • To investigate the etiology of psoas bursal collections found during revision hip arthroplasty.
  • To determine the incidence of such collections in failed resurfacing hip arthroplasties.
  • To differentiate between infectious and non-infectious causes.

Main Methods:

  • Analysis of seven cases of failed resurfacing hip arthroplasty requiring revision.
  • Histological examination of psoas bursa contents.
  • Microbiological investigation of the collected fluid and debris.

Main Results:

  • Seven cases (5.8% incidence) of psoas bursae filled with purulent fluid and debris were identified.
  • Histology confirmed the collections resulted from a tissue response to polyethylene wear debris.
  • Microbiological analysis ruled out infection as the cause in all cases.

Conclusions:

  • Psoas bursal collections in revision hip arthroplasty are primarily a consequence of polyethylene wear debris.
  • These findings are not indicative of infection but rather a reaction to biomaterial wear.
  • Understanding this etiology is crucial for managing failed hip arthroplasties.

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