Growth of an intrapelvic pseudotumor associated with a metal-on-metal total hip arthroplasty after revision arthroplasty causing a femoral nerve neuropathy.
The development of pseudotumors is not uncommon with metal-on-metal total hip arthroplasty. Pseudotumors that dissect into the retroperitoneal space can cause symptoms of nerve compression. We describe a case of a 53-year-old male with a metal-on-metal total hip arthroplasty who developed mild symptoms of a femoral nerve neuropathy 6 years postoperatively. Revision arthroplasty to a ceramic-on-polyethylene articulation and debridement of the pseudotumor was performed. Postoperatively, the patient's femoral neuropathy progressed and a repeat magnetic resonance imaging showed an increase in size of the pseudotumor despite the removal of the offending metal-on-metal articulation. The patient subsequently underwent a laparoscopic excision of the retroperitoneal pseudotumor. By 17 months post laparoscopic excision of the pseudotumor, the patient's motor deficits resolved, however, sensory deficits persisted in the anteromedial thigh.
Department of Orthopedic Surgery, University of Chicago, Chicago, IL, USA.
Patrick
P
Leung
Department of Orthopedic Surgery, NorthShore Medical Group, University of Chicago Pritzker School of Medicine, Glenview, IL, USA.
James C
JC
Kudrna
Femoral nerve neuropathy; Metal-on-metal total hip arthroplasty; Pseudotumor