Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10696
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
Metal-on-metal (MoM) total hip arthroplasty (THA) has been associated with adverse reactions to metal debris, presenting clinically as pseudotumors.
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.
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.