Metallosis following hip arthroplasty: two case reports

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Toxicology

Background:

• Metal-on-polyethylene and metal-on-metal hip arthroplasties can release metal ions and nanoparticles.
• This release can lead to adverse local tissue reactions, including pseudotumors.
• Pseudotumors can cause significant pain, soft-tissue destruction, and neurovascular compression.

Observation:

• Two cases of hip arthroplasty pseudotumors are presented.
• Case 1: A 60-year-old female with a large pseudotumor involving intrapelvic and vascular structures after metal-on-polyethylene arthroplasty.
• Case 2: A 64-year-old female with a pseudotumor near femoral vessels after metal-on-metal hip resurfacing.

Findings:

• Both pseudotumors required complex excision involving multidisciplinary surgical teams (orthopedic, vascular, and general surgery).
• Revision total hip reconstruction was performed in both cases.
• The cases highlight the challenges of extensive pseudotumor excision with vascular and intrapelvic involvement.

Implications:

• Limited literature exists on the extensive excision of hip arthroplasty-associated pseudotumors.
• Multidisciplinary team involvement is crucial for comprehensive pseudotumor excision.
• This approach aims to minimize complications and improve patient outcomes in complex cases.