Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report
Introduction: Adverse local tissue reactions (ALTRs) is a known complication post total hip arthroplasty (THA). ALTR is usually associated with cobalt chromium alloy joints with incidence rate of 36–61%. It has also been documented in mixed bearings such as metal on polyethylene. Although uncommon,...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Indian Orthopaedic Research Group
2025-08-01
|
| Series: | Journal of Orthopaedic Case Reports |
| Subjects: | |
| Online Access: | https://jocr.co.in/wp/2025/08/01/unexplained-pseudotumor-formation-in-ceramic-on-ceramic-hip-bearings-a-case-report/ |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849404545482883072 |
|---|---|
| author | Prithvi Mohandas Sunil D Magadum J Ram Prasad Mahesh Karthick Umesh Kumar Singh Bhagyalakshmi Purushothaman |
| author_facet | Prithvi Mohandas Sunil D Magadum J Ram Prasad Mahesh Karthick Umesh Kumar Singh Bhagyalakshmi Purushothaman |
| author_sort | Prithvi Mohandas |
| collection | DOAJ |
| description | Introduction:
Adverse local tissue reactions (ALTRs) is a known complication post total hip arthroplasty (THA). ALTR is usually associated with cobalt chromium alloy joints with incidence rate of 36–61%. It has also been documented in mixed bearings such as metal on polyethylene. Although uncommon, pseudotumor formation has been reported in ceramic on ceramic (CoC) THA, suggesting that the ceramic debris is not entirely inert.
Case Report:
This case study relates the history of a 56-year-old man with ankylosing spondylitis who underwent bilateral THA using a CoC articulations. Initially asymptomatic for 4 years, he developed pain, swelling around the right hip, and his imaging showed extensive osteolysis with pseudotumor formation. His fine-needle aspiration cytology report was inconclusive, so he underwent stage 1 procedure that is removal of prosthesis and biopsy. His histopathology report confirmed pseudotumor formation with presence of fibrin, proliferating fibroblasts, hemosiderin-laden macrophages and lymphocytes. Since the patient was not keen on second stage revision arthroplasty, he was mobilized with heel and sole raise and walking aid.
Conclusion:
Pseudotumor formation occurred without any damage to ceramic head and liner, without any malposition of components, with no impingement between components and normal metal ion levels in our case. This case report further strengthen existing literature about pseudotumor formation in CoC articulation. Further studies needed to know exact tribology and individual immune response for ceramic wear debris. |
| format | Article |
| id | doaj-art-420745f10eeb47ee8cde4fecbe049a5e |
| institution | Kabale University |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-420745f10eeb47ee8cde4fecbe049a5e2025-08-20T03:36:58ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-08-01158182310.13107/jocr.2025.v15.i08.5868Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case ReportPrithvi MohandasSunil D MagadumJ Ram PrasadMahesh KarthickUmesh Kumar SinghBhagyalakshmi PurushothamanIntroduction: Adverse local tissue reactions (ALTRs) is a known complication post total hip arthroplasty (THA). ALTR is usually associated with cobalt chromium alloy joints with incidence rate of 36–61%. It has also been documented in mixed bearings such as metal on polyethylene. Although uncommon, pseudotumor formation has been reported in ceramic on ceramic (CoC) THA, suggesting that the ceramic debris is not entirely inert. Case Report: This case study relates the history of a 56-year-old man with ankylosing spondylitis who underwent bilateral THA using a CoC articulations. Initially asymptomatic for 4 years, he developed pain, swelling around the right hip, and his imaging showed extensive osteolysis with pseudotumor formation. His fine-needle aspiration cytology report was inconclusive, so he underwent stage 1 procedure that is removal of prosthesis and biopsy. His histopathology report confirmed pseudotumor formation with presence of fibrin, proliferating fibroblasts, hemosiderin-laden macrophages and lymphocytes. Since the patient was not keen on second stage revision arthroplasty, he was mobilized with heel and sole raise and walking aid. Conclusion: Pseudotumor formation occurred without any damage to ceramic head and liner, without any malposition of components, with no impingement between components and normal metal ion levels in our case. This case report further strengthen existing literature about pseudotumor formation in CoC articulation. Further studies needed to know exact tribology and individual immune response for ceramic wear debris.https://jocr.co.in/wp/2025/08/01/unexplained-pseudotumor-formation-in-ceramic-on-ceramic-hip-bearings-a-case-report/adverse local tissue reactionpseudotumorceramic on ceramic total hip arthroplasty |
| spellingShingle | Prithvi Mohandas Sunil D Magadum J Ram Prasad Mahesh Karthick Umesh Kumar Singh Bhagyalakshmi Purushothaman Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report Journal of Orthopaedic Case Reports adverse local tissue reaction pseudotumor ceramic on ceramic total hip arthroplasty |
| title | Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report |
| title_full | Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report |
| title_fullStr | Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report |
| title_full_unstemmed | Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report |
| title_short | Unexplained Pseudotumor Formation in Ceramic-on-ceramic Hip Bearings: A Case Report |
| title_sort | unexplained pseudotumor formation in ceramic on ceramic hip bearings a case report |
| topic | adverse local tissue reaction pseudotumor ceramic on ceramic total hip arthroplasty |
| url | https://jocr.co.in/wp/2025/08/01/unexplained-pseudotumor-formation-in-ceramic-on-ceramic-hip-bearings-a-case-report/ |
| work_keys_str_mv | AT prithvimohandas unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport AT sunildmagadum unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport AT jramprasad unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport AT maheshkarthick unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport AT umeshkumarsingh unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport AT bhagyalakshmipurushothaman unexplainedpseudotumorformationinceramiconceramichipbearingsacasereport |