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, including a severe inflammatory response called aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL), pseudotumor, metallosis, cell death and peri-prosthetic soft tissue/bone necrosis as well as other health-related concerns ( 4 ). Due to high

lymphocytic-dominated vasculitis associated lesion (ALVAL), 20 later expanded to adverse local tissue reactions (ALTR) 21 and adverse reactions to metal debris (ARMD) 22 associated with metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) and

‘aseptic lymphocytic vasculitis-associated lesion’ (ALVAL) is reserved for histological findings; 33 the term ‘metallosis’ should be avoided for these cases. Pseudotumours can be solid, cystic lesions that have a direct communication with the joint

-on-ceramic Breakage and squeaking Metal-on-metal ARMD (ALVAL, high ion levels, osteolysis, pseudotumours) Notes : XLPE, highly cross-linked polyethylene; ARMD, adverse reaction to metal debris; ALVAL, aseptic lymphocyte-dominant, vasculitis

metal debris, which are summarized under the name ‘adverse reactions to metal debris (ARMD). Inflammatory pseudotumours, aseptic lymphocytic vasculitis associated lesions (ALVALs) and metallosis are all examples of ARMDs. The spectrum of ARMD is wide and

of aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) . Clin Radiol 2013 ; 68 : 1089 - 1096 . 29 Anderson H , Toms AP , Cahir JG , et al. . Grading the severity of soft tissue changes associated

-associated lesion (ALVAL). Aim The aim of this systematic review was to find and review all relevant studies to establish outcomes following THR with an MDM construct, with a particular focus on ARMD. Methods Study criteria Inclusion criteria

-associated lesion (ALVAL) were excluded. Types of interventions The description of intervention was not necessary for inclusion, as patients may have died from cobalt toxicity before intervention could be initiated. In some cases, a revision arthroplasty or