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Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesion as Early as Six Weeks After Total Hip Replacement: A Case Report

Case: A 40-year-old man who underwent total hip replacement on the left side with a metal-on-metal (MOM) implant reported swelling at the operative site within 6 weeks of the arthroplasty. Tissue sampled during the revision arthroplasty showed an aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL). Conclusion: ALVAL is a widely recognized complication of MOM hip implants and needs to be considered early, even in completely asymptomatic patients with normal metal ion levels and normal radiographs.