Incidence of Pseudotumor and Acute Lymphocytic Vasculitis Associated Lesion (ALVAL) Reactions in Metal-On-Metal Hip Articulations: A Meta-Analysis

University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
The Journal of arthroplasty (Impact Factor: 2.67). 05/2013; 28(7). DOI: 10.1016/j.arth.2013.03.027
Source: PubMed


We systematically reviewed the peer-reviewed literature to determine a pooled estimate of the incidence of pseudotumor and acute lymphocytic vasculitis associated lesions (ALVAL) in adult patients with primary metal-on-metal (MoM) total hip arthroplasty or resurfacing. Fourteen eligible articles were identified, with a total of 13,898 MoM hips. The incidence of pseudotumor/ALVAL ranged from 0% to 6.5% of hips with a mean follow-up ranging from 1.7 to 12.3years across the studies. The pooled estimated incidence of pseudotumor/ALVAL is 0.6% (95% CI: 0.3% to 1.2%). The rate of revision for any reason ranged from 0% to 14.3% of hips, with a pooled estimate of 3.9% (95% CI: 2.7% to 5.3%).

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