Lin IH, Tsai CH. Tigecycline sclerotherapy for recurrent pseudotumor in aseptic lymphocyte-dominant vasculitis-associated lesion after metal-on-metal total hip arthroplasty: A case report. World J Clin Cases 2021; 9(34): 10696-10701 [PMID: 35005003 DOI: 10.12998/wjcc.v9.i34.10696]
Corresponding Author of This Article
Chun-Hao Tsai, MD, PhD, Attending Doctor, Department of Orthopedics, China Medical University Hospital, China Medical University, No. 100 Sec. 1, Jingmao Road, Beitun District, Taichung 406040, Taiwan. ritsai8615@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2021; 9(34): 10696-10701 Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10696
Tigecycline sclerotherapy for recurrent pseudotumor in aseptic lymphocyte-dominant vasculitis-associated lesion after metal-on-metal total hip arthroplasty: A case report
I-Hao Lin, Chun-Hao Tsai
I-Hao Lin, Chun-Hao Tsai, Department of Orthopedics, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan
Chun-Hao Tsai, School of Medicine, China Medical University, Taichung 406040, Taiwan
Chun-Hao Tsai, Department of Sports Medicine, China Medical University, Taichung 406040, Taiwan
Author contributions: Tsai CH contributed to the study concept and design; Lin IH and Tsai CH performed data acquisition, Lin IH contributed to manuscript writing; Tsai CH critically revised manuscript, and Lin IH and Tsai CH gave final approval of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Hao Tsai, MD, PhD, Attending Doctor, Department of Orthopedics, China Medical University Hospital, China Medical University, No. 100 Sec. 1, Jingmao Road, Beitun District, Taichung 406040, Taiwan. ritsai8615@gmail.com
Received: June 2, 2021 Peer-review started: June 2, 2021 First decision: June 25, 2021 Revised: July 6, 2021 Accepted: October 20, 2021 Article in press: October 20, 2021 Published online: December 6, 2021
Abstract
BACKGROUND
Metal-on-metal (MoM) total hip arthroplasty (THA) has been associated with adverse reactions to metal debris, presenting clinically as pseudotumors.
CASE SUMMARY
This case report presents a female aged 73 year-old with MoM THA-related pseudotumor. After arthrotomy and bursectomy surgeries, histologic examinations of surgical specimens revealed a specific lymphocyte-dominant immunologic response, now known as aseptic lymphocyte-dominant vasculitis-associated lesion (ALVAL). Due to soft tissue persisting effusion after arthrotomy and bursectomy, revision surgery was then performed with ceramic-on-polyethylene THA. However, revision did not resolve the patient’s symptoms. Here we describe our application of tigecycline sclerotherapy to treat recurrent pseudotumor after revision THA and no recurrence after 24-mo follow-up.
CONCLUSION
Tigecycline sclerotherapy is safe and effective in the management of recurrent pseudotumor after revision non-MoM THA in ALVAL cases.
Core Tip: Metal-on-metal (MoM) total hip arthroplasty (THA) often associates with metal debris, presenting as pseudotumors. We here described a case with MoM THA-related pseudotumor. Revision surgery was performed; however, further histologic examinations revealed the presence of aseptic lymphocyte-dominant vasculitis-associated lesion (ALVAL) and recurrent pseudotumors formation was noted after revision THA. We locally injected an infusion of tigecycline sclerotherapy for treating the pseudotumor successfully. Our findings indicated that tigecycline sclerotherapy is safe and effective in managing recurrent pseudotumor after revision non-MoM THA in ALVAL cases.
