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Revista Brasileira de Ortopedia
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Revista Brasileira de Ortopedia
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Revista Brasileira de Ortopedia
Article . 2015
License: CC BY NC ND
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Formação de pseudotumor na artroplastia total do quadril com par tribológico metal‐polietileno

Authors: Fagotti, Lorenzo; Vicente, José Ricardo Negreiros; Miyahara, Helder Souza; Oliveira, Pedro Vitoriano de; Bernabé, Antônio Carlos; Croci, Alberto Tesconi;

Formação de pseudotumor na artroplastia total do quadril com par tribológico metal‐polietileno

Abstract

ResumoRelatar o caso de um paciente adulto jovem que evoluiu com tumoração na coxa esquerda após 14 anos de uma cirurgia de revisão de artroplastia do quadril. Davies em 2005 descreveu esta afecção em pacientes submetidos a atroplastia de quadril com par tribológico metal‐metal, mas na última década é possível achar relatos de pseudotumores em superfície metal‐polietileno. O paciente iniciou queixa de aumento de volume da coxa esquerda após oito anos da cirurgia de revisão da artroplastia do quadril. Dois anos antes do aparecimento da tumoração da coxa, a investigação para descartar um processo neoplásico maligno de um nódulo em região inguinal foi inconclusiva. Suas principais queixas pré‐operatórias eram dor, limitação funcional e marcada redução da amplitude de movimento do quadril esquerdo. As radiografias do membro acometido evidenciavam soltura dos componentes acetabular e femoral, e uma grande massa entre os planos musculares se revelou à ressonância magnética da coxa esquerda. A abordagem cirúrgica consistiu de ressecção intralesional da coxa esquerda, seguida da retirada dos componentes pela via lateral direta. No âmbito da cirurgia de artroplastia de quadril, os pseudotumores são neoplasias benignas cujo par tribológico consiste em metal ‐metal, mas podem também ocorrer em diferentes pares tribológicos, como neste caso.AbstractThe aim here was to report a case of a young adult patient who evolved with tumor formation in the left thigh, 14 years after revision surgery on hip arthroplasty. Davies in 2005 made the first description of this disease in patients undergoing metal‐on‐metal hip arthroplasty. Over the last decade, however, pseudotumors around metal‐on‐polyethylene surfaces have become more prevalent. Our patient presented with increased volume of the left thigh eight years after hip arthroplasty revision surgery. Two years before the arising of the tumor in the thigh, a nodule in the inguinal region was investigated to rule out a malignant neoplastic process, but the results were inconclusive. The main preoperative complaints were pain, functional limitation and marked reduction in the range of motion of the left hip. Plain radiographs showed loosening of acetabular and femoral, and a large mass between the muscle planes was revealed through magnetic resonance imaging of the left thigh. The surgical procedure consisted of resection of the lesion and removal of the components through lateral approach. In respect of total hip arthroplasty, pseudotumors are benign neoplasms in which the bearing surface consists of metal‐on‐metal, but they can also occur in different tribological pairs, as presented in this case.

Keywords

Orthopedics, Granuloma of plasma cells, Hip arthroplasty, Surgery, Artroplastia de quadril, Granuloma de células plasmáticas, Ortopédica

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
Average
gold