Limits...
Metal on metal total hip arthroplasty and a large groin mass: Not always adverse reaction to metallic debris.

Krishnan H, Magnussen A, Sharma A, Skinner J - Int J Surg Case Rep (2014)

Bottom Line: Due to their improved wear rates, Metal-on-metal bearings have been increasingly used in the past decade by orthopaedic surgeons carrying out total hip arthroplasty.We present two cases where an intra-pelvic mass in patients with metal-on-metal implants were diagnosed as being of a different aetiology.This highlights the need for careful assessment of such patients in order to guide appropriate management.

View Article: PubMed Central - PubMed

Affiliation: Spr Trauma and Orthopaedics, Northwick Park Hospital, UK. Electronic address: harry.krishnan02@imperial.ac.uk.

No MeSH data available.


Related in: MedlinePlus

Pre operative AP pelvic radiograph demonstrates bilateral metal on metal total hip replacements.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4337929&req=5

fig0005: Pre operative AP pelvic radiograph demonstrates bilateral metal on metal total hip replacements.

Mentions: Plain radiographs of the pelvis and hip showed a right MoM THA in a satisfactory position with no features of loosening, osteolysis or wear (Fig. 1). The white cell count was 8.4 × 109/L, erythrocyte sedimentation rate 7 mm/h and C reactive protein <1 mg/L. Serum metal ion levels were elevated: chromium (Cr) 10 ppb (normal range 0–0.5 ppb) and cobalt (Co) 12 ppb (normal range 0–0.4 ppb). Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) identified a 23 cm × 13 cm × 5.7 cm purely fatty mass extending from the pelvis lying lateral to the distal psoas muscle to the iliopsoas tendon insertion in the proximal thigh (Fig. 2). It surrounded the femoral vessels in the proximal thigh region and also extended between the lesser trochanter and the ischium. The appearances were consistent with an atypical lipomatous tumour.


Metal on metal total hip arthroplasty and a large groin mass: Not always adverse reaction to metallic debris.

Krishnan H, Magnussen A, Sharma A, Skinner J - Int J Surg Case Rep (2014)

Pre operative AP pelvic radiograph demonstrates bilateral metal on metal total hip replacements.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4337929&req=5

fig0005: Pre operative AP pelvic radiograph demonstrates bilateral metal on metal total hip replacements.
Mentions: Plain radiographs of the pelvis and hip showed a right MoM THA in a satisfactory position with no features of loosening, osteolysis or wear (Fig. 1). The white cell count was 8.4 × 109/L, erythrocyte sedimentation rate 7 mm/h and C reactive protein <1 mg/L. Serum metal ion levels were elevated: chromium (Cr) 10 ppb (normal range 0–0.5 ppb) and cobalt (Co) 12 ppb (normal range 0–0.4 ppb). Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) identified a 23 cm × 13 cm × 5.7 cm purely fatty mass extending from the pelvis lying lateral to the distal psoas muscle to the iliopsoas tendon insertion in the proximal thigh (Fig. 2). It surrounded the femoral vessels in the proximal thigh region and also extended between the lesser trochanter and the ischium. The appearances were consistent with an atypical lipomatous tumour.

Bottom Line: Due to their improved wear rates, Metal-on-metal bearings have been increasingly used in the past decade by orthopaedic surgeons carrying out total hip arthroplasty.We present two cases where an intra-pelvic mass in patients with metal-on-metal implants were diagnosed as being of a different aetiology.This highlights the need for careful assessment of such patients in order to guide appropriate management.

View Article: PubMed Central - PubMed

Affiliation: Spr Trauma and Orthopaedics, Northwick Park Hospital, UK. Electronic address: harry.krishnan02@imperial.ac.uk.

No MeSH data available.


Related in: MedlinePlus