Chronic Expanding Hematomas That Occurred 20 Years or More After Primary Total Hip Arthroplasty: A Report of 2 Cases

JBJS Case Connect. 2021 Mar 2;11(1). doi: 10.2106/JBJS.CC.20.00619.


Case: We report 2 patients who developed chronic expanding hematomas (CEHs) more than 20 years after ceramic-on-polyethylene total hip arthroplasty (THA). One CEH occurred after a minor fall, and the other appeared with no obvious injury. Neither of the 2 was on anticoagulation. Each caused extensive osteolysis.

Conclusion: The only 2 previously reported post-THA cases of CEH involved metal-on-metal THAs and occurred several years after the index THA. Our patients show that CEH also can occur after ceramic-on-polyethylene THA, even after an uneventful clinical course of more than 20 years. Complete removal of both hematoma stopped osteolytic progression, with no recurrence to date.

Publication types

  • Case Reports

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Hematoma / surgery
  • Hip Joint / surgery
  • Hip Prosthesis*
  • Humans
  • Prosthesis Design
  • Prosthesis Failure
  • Retrospective Studies