In a number of case reports, purulence was found during revision but infection remained unconfirmed (Biant et al. 2010, Blumenfeld et al. 2010, Molvik et al. 2010).
According to previously described criteria (Reito et al. 2013), failure was classified to be secondary to ARMD if metallosis, macroscopic synovitis, and/or extracapsular pseudotumors were found during revision and/or a moderate to high number of perivascular lymphocytes along with tissue necrosis and/or fibrin deposition was seen in the histopathological sample.
Our findings suggest that even when a clinically and radiologically intact component is found during surgery, revision of both components of the prosthesis may be recommendable.
No revision surgeries were required and no pseudarthrosis was found during the follow-up period.
Failure was considered to be secondary to ARMD if metallosis, macroscopic synovitis, and/or extracapsular pseudotumors were found during revision and/or a moderate-to-large amount of perivascular lymphocytes along with tissue necrosis and/or fibrin deposition was seen in the histopathological sample (Reito et al. 2013).
4 fluid-filled pseudotumors and 1 mixed-type pseudotumor were also seen in preoperative US but they were not found during revision surgery (here, mean time between US and revision was 4.5 (2.1 7.3) months for the fluid-filled pseudotumors and the actual time was 4.4 months for the mixed-type pseudotumor).
All 7 pseudotumors that were not detected with US were fluid-filled (here, mean time between US and revision was 3.8 (1.3 6.1) months). 1 solid and 2 fluid-filled pseudotumors seen in preoperative US were not found during revision surgery (here, time between US and revision was 3.2 months for the solid pseudotumor and 2.1 and 8.0 months for the fluid-filled pseudotumors).
9 pseudotumors seen in preoperative MRI were not found during revision surgery.
A revision of the GA can be found in a tutorial [24], where the authors provide the revision's more relevant features.
In the present study, 11 fluid-filled pseudotumors were found at revision but not at the preoperative US, and 6 fluid-filled pseudotumors were seen at the US but not at revision. 1 mixed-type pseudotumor seen by US in the trochanteric region and 1 solid pseudotumor seen in the iliopsoas region were also not found during revision surgery.
