Gossypiboma and Total Hip Arthroplasty -- A Rare Accidental Finding Following a Periprosthetic Infection

Gossypiboma or textiloma is the technical term used to describe a surgical complication related to accidental retention of surgical material within the body, most often surgical swabs. Since it is rare in orthopedic surgery, its diagnostis is less common and often initially mistaken with soft-tissue tumors. The aim of this study is to point out the importance of this differential diagnosis in the event of clinical swelling or accidental intraoperative finding associated with previous surgery.

Female patient presenting with 3 weeks hip pain and inflammatory signs, with a past history of a total hip arthroplasty 15 years before.Analytically presented C-reactive protein CRP of 13.67 mg/dl. Ultrasound and computed tomography CT scan revealed a solid lesion in the anterior thigh root and a liquid lesion in the lateral region of the hip.

Gossypibomas can be classified into two types: The aseptic fibrous type, which produces adhesions and a fibrotic capsule, and the exudative type, which is characterized by abscess formation. This case report refers to an aseptic fibrous type, given an asymptomatic evolution over 15 years and histopathological findings. However, this diagnosis occurred following a periprosthetic hip infection.