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Updated: Feb 16, 2026

Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesion as Early as Six Weeks After Total Hip Replacement: A Case
Sajid Khawaja1, Graeme Holt, Aman Khan
1University Hospital Crosshouse, Kilmarnock, United Kingdom.
Case:
A 40-year-old man who underwent total hip replacement on the left side with a metal-on-metal (MOM) implant reported swelling at the operative site within 6 weeks of the arthroplasty. Tissue sampled during the revision arthroplasty showed an aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL).
Conclusion:
ALVAL is a widely recognized complication of MOM hip implants and needs to be considered early, even in completely asymptomatic patients with normal metal ion levels and normal radiographs.
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