{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:16:05Z","timestamp":1788315365782,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of pseudotumors following hip arthroplasty remains a subject of debate. This study aims to assess implant survival in relation to clinical variables and compares the outcomes of one\u2010stage and two\u2010stage revision surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 55 cases of pseudotumor surgically treated between 2004 and 2023 at a single tertiary care center. Patients underwent either one\u2010stage (44%) or two\u2010stage (29%) revision procedures. The following clinical and demographical information were collected: gender, age at diagnosis, body mass index (BMI) (calculated by dividing the patients' weight by their height squared solid mass), the American Society of Anaesthesiologist values (ASA), a diagnosis of pseudotumor identified by radiology and histological examination, time of diagnosis, surgery treatment, and follow\u2010up. Implant and patient survival were estimated using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean follow\u2010up was up to 67\u2009months (95% CI 43.43\u201395.29), and the mean age at diagnosis was 56\u2009years (95% CI 53\u201359). Revision strategy correlated with CRP levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and tumor size (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Ten complications (18%) occurred at a mean of 10\u2009months, including wound issues (1), dislocations (4), abductor dysfunctions (4), and deep infection (1). Implant failure occurred in 3 cases (5%). Implant survival was 92% at 5\u2009years (95% CI 0.68\u20130.97) and 80% at 10\u2009years (95% CI 0.44\u20130.94). Fourteen patients died by final follow\u2010up; 2 deaths (14%) were surgery related. Overall patient survival was 83% at 5\u2009years (95% CI 0.68\u20130.92) and 67% at 10\u2009years (95% CI 0.48\u20130.80). Postoperative Harris Hip Score (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934) averaged 73.2 (95% CI 68.6\u201377.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgery is recommended for pseudotumor, although the optimal approach remains argued. Our data support a two\u2010stage revision for large pseudotumors with elevated inflammatory markers. Revision surgery provides good function and low implant failure risk, but patient mortality remains significant due to fragility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70349","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:45:02Z","timestamp":1783597502000},"page":"1904-1915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Analysis of Pseudotumor of the Hip: Clinical Management and Outcomes"],"prefix":"10.1111","volume":"18","author":[{"given":"Roberta","family":"Laranga","sequence":"first","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3190-1034","authenticated-orcid":false,"given":"Luca","family":"Cevolani","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Lodewijk","family":"Staals","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mammone","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Campanacci","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Dozza","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9170-0576","authenticated-orcid":false,"given":"Davide Maria","family":"Donati","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Unit of 3rd Orthopedic and Traumatologic Clinic Prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, via Pupilli 1  Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/2156-7514.181493"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1372-y"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.05.030"},{"key":"e_1_2_13_5_1","first-page":"164","article-title":"Adverse Reaction to Metal Debris Following Hip Resurfacing: The Influence of Component Type, Orientation and Volumetric Wear","volume":"93","author":"Langton D. J.","year":"2011","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"key":"e_1_2_13_6_1","first-page":"738","article-title":"The Painful Metal\u2010On\u2010Metal Hip Resurfacing","volume":"91","author":"Hart A. J.","year":"2009","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.07.011"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.109374"},{"key":"e_1_2_13_9_1","first-page":"86","article-title":"Pseudotumors Associated With Total Hip Arthroplasty","volume":"94","author":"Daniel J.","year":"2012","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_13_10_1","first-page":"1019","article-title":"Hip Resurfacings Revised for Inflammatory Pseudotumour Have a Poor Outcome","volume":"91","author":"Grammatopolous G.","year":"2009","journal-title":"Journal of Bone and Joint Surgery. British Volume"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01715"},{"key":"e_1_2_13_12_1","first-page":"147","article-title":"The Current State of Bearing Surfaces in Total Hip Replacement","volume":"96","author":"Rajpura A.","year":"2014","journal-title":"Bone & Joint Journal"},{"key":"e_1_2_13_13_1","first-page":"847","article-title":"Pseudotumours Associated With Metal\u2010On\u2010Metal Hip Resurfacings","volume":"90","author":"Pandit H.","year":"2008","journal-title":"Journal of Bone & Joint Surgery British Volume"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13030815"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2001.23716"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.03.027"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/biores.2017.0035"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1198-743X.2004.00722.x"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.71.BJR-2017-0323"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2944-4"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-015-2165-2"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.02.011"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2979-6"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v7.i5.272"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/jfb6030486"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.06.021"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.21037\/aoj\u201022\u201045"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-23-0066"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-020-04523-y"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1603676"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70349","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.70349","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:01:12Z","timestamp":1788314472000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/os.70349"],"URL":"https:\/\/doi.org\/10.1111\/os.70349","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]},"assertion":[{"value":"2025-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}