Metal-on-metal total hip arthroplasty adverse local tissue reaction with intermittent unilateral vascular claudication

Abstract

Osteolysis and adverse local soft-tissue reactions are well-documented complications of metal-on-metal prosthetic implants. This case report describes a 68-year-old man who presented to the clinic 10 years after staged bilateral metal-on-metal total hip arthroplasty revisions with the primary complaint of groin pain, intermittent right leg pain, swelling, and muscle cramping while ambulating that resolved with rest. A complete workup was negative for deep venous thrombosis and infection. His symptoms were found to be secondary to an iliopsoas bursal mass externally compressing the femoral vasculature resulting in vascular claudication. He was treated with revision arthroplasty and drainage of the fluid within the iliopsoas bursal effusion with symptomatic resolution. Keywords: Metallosis, Metal-on-metal, Total hip arthroplasty, THA, Revision arthroplasty, Adverse local tissue reaction, Pseudotumor, Mechanically assisted crevice corrosion