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Symptomatic abnormal periprosthetic soft-tissue reactions ("pseudotumors") have been reported after metal-on-metal hip resurfacing arthroplasty (MoMHRA). The aims of this study were (1) to determine the prevalence of asymptomatic pseudotumors after MoMHRA and (2) to measure metal ion levels in these patients. A total of 201 hips in 158 patients were evaluated at a mean follow-up of 61 months (range, 36-88) using ultrasound/magnetic resonance imaging and serum/hip aspirate cobalt and chromium measurements. Pseudotumors found in 7 patients (4%) were associated with significantly higher cobalt and chromium levels and inferior functional scores. Elevated levels of cobalt and chromium ions suggest that pseudotumors are associated with increased wear generated from metal-on-metal articulations. Clinicians need to be aware of pseudotumors as a differential diagnosis during clinical evaluation of MoMHRA patients, and further imaging such as ultrasound or magnetic resonance imaging is recommended to confirm the diagnosis.

Type

Journal article

Journal

The Journal of arthroplasty

Publication Date

06/2011

Volume

26

Pages

511 - 518

Addresses

Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02116, USA.

Keywords

Humans, Osteoarthritis, Hip, Soft Tissue Injuries, Granuloma, Plasma Cell, Chromium, Cobalt, Metals, Magnetic Resonance Imaging, Ultrasonography, Arthroplasty, Replacement, Hip, Prevalence, Retrospective Studies, Hip Prosthesis, Adult, Aged, Middle Aged, Female, Male