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Pseudotumor Formation in a Metal-on-polyethylene Total Hip Arthroplasty Due to Trunnionosis at the Head-neck Taper.

We present here a case of pseudotumor formation likely due to metal wear debris generated at the head-neck taper (trunnion) of the femoral stem and head components in a metal-on-polyethylene (MOP) total hip arthroplasty. Over the last few years, this recently described diagnosis, trunnionosis, has been recognized and reported more frequently. This patient presented with a rather large (12-cm diameter) pseudotumor with accompanying loss of abductors and a pelvic discontinuity making reconstruction more challenging. We believe the psuedotumor in this patient developed from trunnionosis. This is an interesting case of aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) in a MOP total hip arthroplasty.