Skip to main content
Erschienen in: Skeletal Radiology 8/2008

01.08.2008 | Scientific Article

The imaging spectrum of peri-articular inflammatory masses following metal-on-metal hip resurfacing

verfasst von: Christopher. S. J. Fang, Paul Harvie, Christopher L. M. H. Gibbons, Duncan Whitwell, Nicholas A. Athanasou, Simon Ostlere

Erschienen in: Skeletal Radiology | Ausgabe 8/2008

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Resurfacing metal-on-metal hip arthroplasty is increasing in popularity, especially in younger patients. To date, studies indicate that the procedure is associated with a good outcome in the medium-term. Formation of a peri-articuar mass is a rarely reported complication. In this study we analyse the imaging findings in patients with resurfacing implants presenting to our institution with peri-articular masses identified on cross sectional imaging.

Materials and methods

All patients with documented peri-articular masses following resurfacing arthroplasty were included. The available imaging related to the masses was reviewed and the findings documented along with the patient’s demographics.

Results

There were 10 patients (13 joints). All patients were female. Patients presented with periprosthetic anterior or posterolateral solid and cystic masses. The anterior masses involved psoas muscle and were predominately solid. The posterolateral masses were predominately cystic. In the three cases with bilateral arthroplasties, masses were detected in both hips. Histology in six cases showed features compatible with a type IV hypersensitivity reaction.

Conclusions

The preponderance of females, the bilateral nature of the masses and the histological features suggest that peri-articular masses following resurfacing arthroplasty is due to the metal hypersensitivity.
Literatur
1.
Zurück zum Zitat Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am 2002; 84-A [Suppl 2]: 2–20.CrossRef Malchau H, Herberts P, Eisler T, Garellick G, Soderman P. The Swedish Total Hip Replacement Register. J Bone Joint Surg Am 2002; 84-A [Suppl 2]: 2–20.CrossRef
2.
Zurück zum Zitat Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA. Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am 2004; 86: 28–39.CrossRef Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA. Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg Am 2004; 86: 28–39.CrossRef
3.
Zurück zum Zitat Daniel J, Pynsent PB, McMinn DJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br 2004; 86: 177–184.CrossRef Daniel J, Pynsent PB, McMinn DJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br 2004; 86: 177–184.CrossRef
4.
Zurück zum Zitat Firkins PJ, Tipper JL, Saadatzadeh MR, et al. Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator. Biomed Mater Eng 2001; 11: 143–157.PubMed Firkins PJ, Tipper JL, Saadatzadeh MR, et al. Quantitative analysis of wear and wear debris from metal-on-metal hip prostheses tested in a physiological hip joint simulator. Biomed Mater Eng 2001; 11: 143–157.PubMed
5.
Zurück zum Zitat Goldsmith AA, Dowson D, Isaac GH, Lancaster JG. A comparative joint simulator study of the wear of metal-on-metal and alternative material combinations in hip replacements. Proc Inst Mech Eng 2000; 214: 39–47.CrossRef Goldsmith AA, Dowson D, Isaac GH, Lancaster JG. A comparative joint simulator study of the wear of metal-on-metal and alternative material combinations in hip replacements. Proc Inst Mech Eng 2000; 214: 39–47.CrossRef
6.
Zurück zum Zitat Visuri T, Pukkala E, Paavolainen P, Pulkkinen P, Riska EB. Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty. Clin Orthop Relat Res 1996; Aug [329 Suppl]: S280–289.CrossRef Visuri T, Pukkala E, Paavolainen P, Pulkkinen P, Riska EB. Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty. Clin Orthop Relat Res 1996; Aug [329 Suppl]: S280–289.CrossRef
7.
Zurück zum Zitat Willert HG, Buchhorn GH, Fayyazi A, et al. Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am 2005; 87: 28–36.CrossRef Willert HG, Buchhorn GH, Fayyazi A, et al. Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study. J Bone Joint Surg Am 2005; 87: 28–36.CrossRef
8.
Zurück zum Zitat Davies AP, Willert HG, Campbell PA, Learmonth ID, Case CP. An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. J Bone Joint Surg Am 2005; 87: 18–27.CrossRef Davies AP, Willert HG, Campbell PA, Learmonth ID, Case CP. An unusual lymphocytic perivascular infiltration in tissues around contemporary metal-on-metal joint replacements. J Bone Joint Surg Am 2005; 87: 18–27.CrossRef
9.
Zurück zum Zitat Boardman DR, Middleton FR, Kavanagh TG. A benign psoas mass following metal-on-metal resurfacing of the hip. J Bone Joint Surg Br 2006; 88: 402–404.CrossRef Boardman DR, Middleton FR, Kavanagh TG. A benign psoas mass following metal-on-metal resurfacing of the hip. J Bone Joint Surg Br 2006; 88: 402–404.CrossRef
10.
Zurück zum Zitat Schuh A, Zeiler G, Holzwarth U, Aigner T. Malignant fibrous histiocytoma at the site of a total hip arthroplasty. Clin Orthop Relat Res 2004; Aug: 218–222. Schuh A, Zeiler G, Holzwarth U, Aigner T. Malignant fibrous histiocytoma at the site of a total hip arthroplasty. Clin Orthop Relat Res 2004; Aug: 218–222.
11.
Zurück zum Zitat Penman HG, Ring PA. Osteosarcoma in association with total hip replacement. J Bone Joint Surg Br 1984; 66: 632–634.CrossRef Penman HG, Ring PA. Osteosarcoma in association with total hip replacement. J Bone Joint Surg Br 1984; 66: 632–634.CrossRef
12.
Zurück zum Zitat Halpin DS. An unusual reaction in muscle in association with Vitallium plate: a report of possible metal hypersensitivity. J Bone Joint Surg Br 1975; 57: 451–453.CrossRef Halpin DS. An unusual reaction in muscle in association with Vitallium plate: a report of possible metal hypersensitivity. J Bone Joint Surg Br 1975; 57: 451–453.CrossRef
13.
Zurück zum Zitat Holgate SJ, Hamblin TJ. The hypersensitivity reaction. In: McGee JO’D, Isaacson PG, Wright NA, Dick HM, Slack MPE, eds. Oxford textbook of pathology. Oxford University Press; 1992: 275–279. Holgate SJ, Hamblin TJ. The hypersensitivity reaction. In: McGee JO’D, Isaacson PG, Wright NA, Dick HM, Slack MPE, eds. Oxford textbook of pathology. Oxford University Press; 1992: 275–279.
14.
Zurück zum Zitat Schnuch A, Uter W, Geier J, Gefeller O. Epidemiology of contact allergy: an estimation of morbidity employing the clinical epidemiology and drug-utilization research (CE-DUR) approach. Contact Dermatitis 2002; 47: 32–39.CrossRef Schnuch A, Uter W, Geier J, Gefeller O. Epidemiology of contact allergy: an estimation of morbidity employing the clinical epidemiology and drug-utilization research (CE-DUR) approach. Contact Dermatitis 2002; 47: 32–39.CrossRef
15.
Zurück zum Zitat Schnuch A, Geier J, Uter W, et al. National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK). Contact Dermatitis 1997; 37: 200–209. Nov.CrossRef Schnuch A, Geier J, Uter W, et al. National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK). Contact Dermatitis 1997; 37: 200–209. Nov.CrossRef
16.
Zurück zum Zitat Benson MK, Goodwin PG, Brostoff J. Metal sensitivity in patients with joint replacement arthroplasties. BMJ 1975; 4: 374–375.CrossRef Benson MK, Goodwin PG, Brostoff J. Metal sensitivity in patients with joint replacement arthroplasties. BMJ 1975; 4: 374–375.CrossRef
17.
Zurück zum Zitat Elves MW, Wilson JN, Scales Joint, Kemp HB. Incidence of metal sensitivity in patients with total joint replacements. BMJ 1975; 4: 376–378.CrossRef Elves MW, Wilson JN, Scales Joint, Kemp HB. Incidence of metal sensitivity in patients with total joint replacements. BMJ 1975; 4: 376–378.CrossRef
18.
Zurück zum Zitat Evans EM, Freeman MA, Miller AJ, Vernon-Roberts B. Metal sensitivity as a cause of bone necrosis and loosening of the prosthesis in total joint replacement. J Bone Joint Surg Br 1974; 56-B: 626–642.CrossRef Evans EM, Freeman MA, Miller AJ, Vernon-Roberts B. Metal sensitivity as a cause of bone necrosis and loosening of the prosthesis in total joint replacement. J Bone Joint Surg Br 1974; 56-B: 626–642.CrossRef
19.
Zurück zum Zitat Jacobs JJ, Hallab NJ. Loosening and osteolysis associated with metal-on-metal bearings: a local effect of metal hypersensitivity? J Bone Joint Surg Am 2006; 88: 1171–1172.PubMed Jacobs JJ, Hallab NJ. Loosening and osteolysis associated with metal-on-metal bearings: a local effect of metal hypersensitivity? J Bone Joint Surg Am 2006; 88: 1171–1172.PubMed
Metadaten
Titel
The imaging spectrum of peri-articular inflammatory masses following metal-on-metal hip resurfacing
verfasst von
Christopher. S. J. Fang
Paul Harvie
Christopher L. M. H. Gibbons
Duncan Whitwell
Nicholas A. Athanasou
Simon Ostlere
Publikationsdatum
01.08.2008
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 8/2008
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-008-0492-x

Weitere Artikel der Ausgabe 8/2008

Skeletal Radiology 8/2008 Zur Ausgabe

Browser's Notes

Browser’s notes

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.