Association Between Pseudotumor Formation and Patient Factors in Metal-on-Metal Total Hip Arthroplasty Population.

Journal Article (Journal Article)

BACKGROUND: Pseudotumor formation from metal-on-metal (MoM) hip implants is associated with implant revision. The relationship between pseudotumor type and patient outcomes is unknown. METHODS: We retrospectively reviewed patients with a MoM total hip arthroplasty and metal artifact reduction sequence magnetic resonance imaging. Pseudotumors were graded using a validated classification system by a fellowship-trained radiologist. Patient demographics, metal ion levels, and implant survival were analyzed. RESULTS: Pseudotumors were present in 49 hips (53%). Thirty-two (65%) pseudotumors were cystic thin walled, 8 (16%) were cystic thick walled, and 9 (18%) were solid masses. Patients with pseudotumors had high offset stems (P = .030) but not higher metal ion levels. Patients with thick-walled cystic or solid masses were more likely to be symptomatic (P = .025) and were at increased risk for revision (P = .004) compared to patients with cystic lesions. CONCLUSION: Pseudotumor formation is present in 53% of patients with a MoM total hip arthroplasty, of which 40% were asymptomatic. Patients with thick-walled cystic and solid lesions were more likely to be symptomatic and undergo revision.

Full Text

Duke Authors

Cited Authors

  • Kleeman, LT; Goltz, D; Seyler, TM; Mammarappallil, JG; Attarian, DE; Wellman, SS; Bolognesi, MP

Published Date

  • July 2018

Published In

Volume / Issue

  • 33 / 7S

Start / End Page

  • S259 - S264

PubMed ID

  • 29691177

Electronic International Standard Serial Number (EISSN)

  • 1532-8406

Digital Object Identifier (DOI)

  • 10.1016/j.arth.2018.03.039


  • eng

Conference Location

  • United States