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Pseudotumor with Superimposed Periprosthetic Infection Following Metal-on-Metal Total Hip ArthroplastyA Case Report
Tyler Steven Watters, MD1; William C. Eward, MD, DVM1; Rhett K. Hallows, MD2; Leslie G. Dodd, MD3; Samuel S. Wellman, MD1; Michael P. Bolognesi, MD1
1 Division of Orthopaedic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tsw9@duke.edu
2 Intermountain Orthopedic Specialty Group, 370 East 9th Avenue, Suite 205, Salt Lake City, UT 84103
3 Division of Soft Tissue and Bone Pathology, Department of Pathology, Duke University Medical Center, Durham, NC 27710
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits of less than $10,000 (Biomet), in excess of $10,000 (Zimmer), and of unknown value (Amedica) or a commitment or agreement to provide such benefits from commercial entities.

Investigation performed at Duke University Medical Center, Durham, North Carolina

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jul 07;92(7):1666-1669. doi: 10.2106/JBJS.I.01208
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Second-generation metal-on-metal bearing surfaces made of modern cobalt-chromium-molybdenum alloys are widely used for total hip arthroplasty in the United States1. While these bearing surfaces offer considerable advantages over conventional metal-on-polyethylene articulations, metal hypersensitivity reactions to these implants are an important, although uncommon, cause of failure2. This unique mode of failure, which has been reported with first-generation implants2,3 and subsequently in association with second-generation metal-on-metal bearing surfaces, appears to be caused by an immunologic delayed hypersensitivity response to metal particles4-6.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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