Arthroplasty Today (Aug 2023)

Onset of Chronic Expanding Hematoma 25 Years After Total Hip Arthroplasty

  • Yugen Ogata, MD,
  • Kosuke Kumagai, MD, PhD,
  • Tomohiro Mimura, MD, PhD,
  • Shunichi Miyahara, MD,
  • Masashi Egawa, MD,
  • Hideki Saito, MD,
  • Yasutaka Amano, MD,
  • Takafumi Yayama, MD, PhD,
  • Mitsuhiko Kubo, MD, PhD,
  • Shinji Imai, MD, PhD

Journal volume & issue
Vol. 22
p. 101168

Abstract

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Chronic expanding hematoma (CEH) is a rare anatomical condition that gradually expands due to trauma or surgery. We report the case of a 56-year-old woman who developed CEH 25 years after metal-on-polyethylene total hip arthroplasty. She presented with swelling and radiating pain in the right inguinal region. Tocilizumab was administered for treating rheumatoid arthritis and renal amyloid A amyloidosis. Diagnostic imaging and partial resection revealed a soft tissue mass and a CEH, respectively. The symptoms recurred 6 months later; dialysis was initiated, and the CEH was resected under general anesthesia, leading to improvement. This case report emphasizes the importance of prompt diagnosis and intervention in CEH management for preventing further complications and improving the patient's quality of life.

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