Antônio Carlos Bernabé

Formation of a pseudotumor in total hip arthroplasty using a tribological metal-polyethylene pair

The 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 8 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.

Remodelamento da otopelve pós artroplastia total do quadril

OBJETIVO: Verificar o remodelamento acetabular atraves dos metodos de Sotelo-Garza e Charnley e da Linha de Kohler ou linha ilio-isquiatica, de pacientes submetidos a artroplastia total do quadril com acetabulo rosqueado tipo CO-10. RESULTADOS: Com relacao a classificacao de Sotelo-Garza e Charnley, tinhamos no pre-operatorio 6 pacientes no grupo I (leve) e 14 pacientes no grupo II (moderada), nao classificando nenhum paciente com protrusao acetabular grave ou maior de 15 mm. No pos-operatorio, o grupo I passou a ter 17 pacientes com somente 3 no grupo II, mantendo-se o grupo III sem nenhum paciente classificado. O paciente que apresentou o maior remodelamento acetabular foi o de maior seguimento da serie (10 anos), diminuindo 9 mm pelo metodo LK e 5 mm pelo metodo de Sotelo-Garza e Charnley. MATERIAIS E METODOS: Foram analisados de maneira retrospectiva e descritos 20 casos de pacientes com Otopelve tratados de 1996 a 2005, submetidos a artroplastia total do quadril com acetabulo rosqueado tipo CO-10. Verificamos o remodelamento acetabular atraves dos metodos de Sotelo-Garza e Charnley e da Linha de Kohler ou linha ilio-isquiatica. CONCLUSAO: Verificamos ser significante o remodelamento do acetabulo com o metodo de tratamento proposto, o que fala a favor do uso de proteses nao cimentadas de apoio acetabular equatorial para tratamento da Otopelve.