Gluteal silicone injections and total hip arthroplasty: a case report

Seeger, Jörn B; Ahmed, Gafar A; Basad, Erhan; Rickert, Markus; Ishaque, Bernd A

INTRODUCTION: Silicone injection is a common procedure in cosmetic surgery. Granuloma formation and migration are the most commonly observed complications. CASE PRESENTATION: We report an unusual case of avascular necrosis of the hip in a 41-year-old woman from Thailand presenting with hip pain. Subcutaneous nodules were observed in the clinical examination. A pelvic X-ray revealed necrosis of the right femoral head and histological analysis of the punctuated nodules showed a reaction of foreign body granulomas. During surgical treatment with a hip replacement solitary silicone cysts were removed. CONCLUSIONS: This case report emphasizes that orthopedic surgeons treating patients with necrosis of the hip joint in combination with palpable granulomas in the gluteal region have to be aware of silicone augmentation and its potential complications before planning a hip replacement.