Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

Tsunehito Ishida, MD, PhD; Toshiyuki Tateiwa, MD, PhD; Yasuhito Takahashi, PhD; Yohei Nishikawa, MD; Takaaki Shishido, MD, PhD; Toshinori Masaoka, MD, PhD; Keiji Sano, MD, PhD; Kengo Yamamoto, MD, PhD

Arthroplasty Today (Sep 2020)

Do Polyethylene Supra-Macroparticles Lead to Pseudotumor Formation in Metal-on-Polyethylene Total Hip Arthroplasty?

Tsunehito Ishida, MD, PhD,
Toshiyuki Tateiwa, MD, PhD,
Yasuhito Takahashi, PhD,
Yohei Nishikawa, MD,
Takaaki Shishido, MD, PhD,
Toshinori Masaoka, MD, PhD,
Keiji Sano, MD, PhD,
Kengo Yamamoto, MD, PhD

Affiliations

Tsunehito Ishida, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan; Corresponding author. 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Tel.: +81 3 3342 6111.
Toshiyuki Tateiwa, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
Yasuhito Takahashi, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan; Department of Bone and Joint Biomaterial Research, Tokyo Medical University, Tokyo, Japan
Yohei Nishikawa, MD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
Takaaki Shishido, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
Toshinori Masaoka, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
Keiji Sano, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
Kengo Yamamoto, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan

Journal volume & issue: Vol. 6, no. 3
pp. 526 – 531

Abstract

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We describe 2 cases of pseudotumors induced by an unusual size of polyethylene wear particle after metal-on-polyethylene total hip arthroplasty (MoP THA). The supra-macroparticles of size >100 μm originated from a polyethylene liner with relatively small cup anteversion, potentially leading to excessive loading and increased wear of the anterior edge of the polyethylene liner. Histopathology showed a foreign-body reaction to the polyethylene particles without an adverse reaction to metal debris and with no severe signs of corrosion at the head-neck junction, which have been noted in past reports of pseudotumors in MoP THA. It has been suggested that the large polyethylene wear particles might be the cause of pseudotumor formation in MoP THA.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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