[Heterotopic excessive wear granuloma mistaken for an aneurysm of the external iliac artery].
Reimplantation of a total hip arthroplasty (THA) with excessive heterotopic polyethylene granuloma is reported. An 84- year-old woman, who had undergone THA reimplantation on the right side 4.5 years previously, was indicated for revision surgery due to aseptic failure of the acetabular component. Pre-operative examination revealed a pulsating mass below the right inguinal ligament that raised the suspicion of a pseudoaneurysm of the external iliac artery. Because of this suspected late complication of the first revision arthroplasty, surgical exploration was indicated by the vascular surgeon prior the second reimplantation. A CT-scan showed a large mass attached to a preserved lumen of the external iliac artery, and this was diagnosed by the vascular surgeon as a pseudoaneurysm. However, no pseudoaneurysm was found by a vascular surgery procedure, and the large mass ventrally extending the external iliac artery appeared to be a large polyethylene granuloma well enveloped in a fibrous pseudocapsula. The granuloma was removed and the wound sutured. Twelve days later, revision total hip arthroplasty and acetabular reconstruction were successfully carried out.
Veselý
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I. Ortopedická klinika 1. LF UK a FN Motol, Praha. filipvesely@centrum.cz
Novotný
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Sosna
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D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000175:diagnosis*; D019644:Arthroplasty, Replacement, Hip; D003937:Diagnosis, Differential; D005260:Female; D015745:Granuloma, Foreign-Body / Q000175:diagnosis*; D006622:Hip Prosthesis; D006801:Humans; D007083:Iliac Artery; D020959:Polyethylene; D012086:Reoperation
D020959:Polyethylene