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Inflammatory Pseudotumor After Total Hip Arthroplasty-An Increasingly Recognized Complication
Steve T L Pambayi1, Zhi Zhao1, Hongjun Peng1
1Department of Orthopedics Surgery, Orthopedics Research Institute, and National Clinical Research Center for Geriatric, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Orthopaedic Surgery
|June 3, 2026
Summary
Inflammatory pseudotumor (IP) is a significant cause of total hip arthroplasty (THA) failure, presenting as a non-infectious mass around the prosthesis. Early diagnosis via imaging and appropriate management are crucial for successful patient outcomes.
Area of Science:
- Orthopedics
- Pathology
- Radiology
Background:
- Inflammatory pseudotumor (IP) is an emerging cause of total hip arthroplasty (THA) failure.
- This non-neoplastic, non-infectious mass can occur with various bearing surfaces, not just metal-on-metal (MoM).
Purpose of the Study:
- To highlight inflammatory pseudotumor as a key etiological factor in THA failure.
- To discuss the risk factors, diagnostic modalities, and management strategies for IP in THA.
Main Methods:
- Review of literature on inflammatory pseudotumor in THA.
- Emphasis on diagnostic imaging techniques like MRI with MARS.
- Correlation of clinical presentation with radiographic findings for management decisions.
Main Results:
- IP can lead to THA failure through mechanical and inflammatory pathways, causing pain, instability, and loosening.
- Multimodal imaging is essential for accurate diagnosis and surgical planning.
- Risk factors include female sex, genetic factors, MoM bearings, large head size, and wear debris.
Conclusions:
- Inflammatory pseudotumor is an important, imaging-detectable cause of THA failure.
- Awareness of IP's presentation and diagnostic features is critical for timely intervention.
- Effective management, from observation to revision surgery, improves patient outcomes.
