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Exuberant Rice Body Formation Associated with Adverse Local Tissue Reaction After Hip Resurfacing Arthroplasty: A
Daniel C Ramirez1, Renee Ren2, Alissa J Burge3
1Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, New York.
Case:
A 65-year-old man with osteoarthritis of the hip developed a soft-tissue mass of the inferior gluteal region 3 years after metal-on-metal resurfacing hip arthroplasty. Clinical and imaging findings suggested an adverse local tissue reaction. Intraoperatively, nearly 1 liter of intra-articular fibrinous loose bodies (rice bodies) was removed, and histology showed features of an adaptive immune response. The patient had no evidence of an autoimmune disease or mycobacterial infection.
Conclusion:
To our knowledge, this is the first reported case of florid rice bodies associated with a metal-on-metal hip arthroplasty and adverse local tissue reaction.
Insights
A rare case of extensive rice bodies, a type of inflammatory response, occurred in a patient following hip resurfacing arthroplasty. This adverse local tissue reaction mimicked other conditions but was linked to the metal-on-metal implant.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Immunology
Background:
- Metal-on-metal hip resurfacing arthroplasty is used for osteoarthritis.
- Adverse local tissue reactions can occur after hip arthroplasty.
- Rice bodies are typically associated with inflammatory joint conditions.
Conclusions:
- This is the first reported case of extensive rice bodies associated with metal-on-metal hip arthroplasty.
- Florid rice bodies can be a manifestation of adverse local tissue reaction to hip implants.
- Further research is needed to understand the immunologic mechanisms involved.
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