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Related Experiment Videos

Pelvic mass causing vesical compression after total hip arthroplasty. Case report.

S J Hattrup1, R S Bryan, T A Gaffey

  • 1Department of Orthopedics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.

Clinical Orthopaedics and Related Research
|February 1, 1988
PubMed
Summary

A loose hip implant caused a rare histiocytic reaction, forming a pelvic mass and urinary issues. Surgical revision and mass removal were necessary for this complication.

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Area of Science:

  • Orthopedic Surgery
  • Pathology
  • Biomaterials Science

Background:

  • Total hip arthroplasty (THA) is a common procedure to address hip joint degeneration.
  • Prosthetic joint loosening and associated complications can occur, necessitating revision surgery.
  • Methylmethacrylate (MMA) bone cement is frequently used in THA, and its debris can elicit biological responses.

Observation:

  • A 59-year-old female patient presented with a pelvic mass and urinary symptoms.
  • Imaging revealed a loose total hip arthroplasty with erosion into the acetabular medial wall.
  • Histopathological examination identified a significant histiocytic response to methylmethacrylate debris.

Findings:

  • The histiocytic reaction to MMA debris led to acetabular erosion and a large pelvic mass.

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  • The pelvic mass caused significant patient morbidity, including urinary dysfunction.
  • Surgical management required a combined abdominal and lateral approach for mass excision and hip revision.

    • Implications:

    • This case highlights a rare but serious complication of THA related to MMA debris.
    • It underscores the importance of considering inflammatory responses to biomaterial debris in the differential diagnosis of pelvic masses near loose prostheses.
    • Multidisciplinary surgical planning is crucial for managing complex cases involving prosthetic joint complications and adjacent mass effect.