{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:51Z","timestamp":1787755311673,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,6,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pseudotumor formation following total hip arthroplasty (THA) is a well-known complication mainly associated with metal-on-metal (MoM) bearings and taper corrosion on modular-neck femoral stems. The purpose of this study was to determine the prevalence of revision surgery for symptomatic pseudotumors in a large cohort of patients treated with primary THA with a standard stem and a non-MoM articulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We included 2,102 patients treated with a total of 2,446 THAs from 1999 until May 2016 in a prospective, observational cohort study. All patients underwent THA with the same uncemented, non-modular-neck femoral stem and metal-on-polyethylene (MoP) (n = 2,409) or ceramic-on-polyethylene (n = 37) articulation. All patients were followed by means of a combination of surgical and medical chart review, follow-up visits, and the Swedish Hip Arthroplasty Register. Metal artifact reduction sequence magnetic resonance imaging (MARS MRI) was used for diagnosis of the pseudotumors, and serum metal ion levels and inflammatory marker levels were measured for all patients who underwent a revision due to pseudotumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The prevalence of revision for symptomatic pseudotumor formation was 0.5% (13 cases) at a mean follow-up time of 7 years. The incidence rate was 0.9 case per 1,000 person-years. All 13 revisions were done in patients with an MoP articulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study demonstrated a 0.5% prevalence of revision due to symptomatic pseudotumor formation in a cohort of patients who underwent THA with a non-MoM construct. Surgeons should be aware that symptomatic pseudotumor formation requiring revision surgery is a tangible complication even after standard MoP THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00616","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T14:30:53Z","timestamp":1528295453000},"page":"942-949","source":"Crossref","is-referenced-by-count":24,"title":["Revision for Symptomatic Pseudotumor After Primary Metal-on-Polyethylene Total Hip Arthroplasty with a Standard Femoral Stem"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1521-4565","authenticated-orcid":false,"given":"Anders","family":"Persson","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Danderyd University Hospital, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Eisler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Danderyd University Hospital, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Bod\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Danderyd University Hospital, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferid","family":"Krupic","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof","family":"Sk\u00f6ldenberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Danderyd University Hospital, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olav","family":"Muren","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Danderyd University Hospital, Karolinska Institute at Danderyd University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"3","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"486","DOI":"10.3390\/jfb6030486","article-title":"Metal-on-metal hip arthroplasty: a review of adverse reactions and patient management","volume":"6","author":"Drummond","year":"2015","journal-title":"J Funct Biomater."},{"issue":"7","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.arth.2013.03.027","article-title":"Incidence of pseudotumor and acute lymphocytic vasculitis associated lesion (ALVAL) reactions in metal-on-metal hip articulations: a meta-analysis","volume":"28","author":"Wiley","year":"2013","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.arth.2015.07.011","article-title":"Prevalence of pseudotumor in patients after metal-on-metal hip arthroplasty evaluated with metal ion analysis and MARS-MRI","volume":"31","author":"Sutphen","year":"2016","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2106\/JBJS.J.01508","article-title":"Pseudotumors in association with well-functioning metal-on-metal hip prostheses: a case-control study using three-dimensional computed tomography and magnetic resonance imaging","volume":"94","author":"Hart","year":"2012","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s00402-015-2165-2","article-title":"Pseudotumor formation and serum ions after large head metal-on-metal stemmed total hip replacement. 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