Failure of a Polyethylene Total Knee Component Presenting as a Thigh Mass

Chavda, Deepak V.; Garvin, Kevin L.

doi:10.1097/00003086-199406000-00028

Cited by 13 publications

(4 citation statements)

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“…Previous studies have reported the formation of pelvic, thigh or calf masses related to osteolysis and wear debris in patients with hip and knee joint arthroplasties [ 1 , 2 , 4 - 11 ]. These masses have been reported up to eight years following primary total joint replacement [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Metastatic carcinomas to bone are rarely located around the knee joint; popliteal cysts, cellulitis, deep vein thrombosis and aneurysms can be evaluated using ultrasonography [1-3]. …”

Section: Introductionmentioning

confidence: 99%

“…Orthopaedic surgeons must consider several pathologic entities for patients presenting with painful, enlarging masses of the knee joint. Among these are primary soft tissue or bone sarcomas, metastatic carcinomas to bone and aneurysms of the popliteal artery, popliteal cysts infection, deep vein thrombosis, or cellulitis [ 1 , 2 ]. Differential diagnosis should also include wear debris and metallosis, and aseptic loosening of the knee prostheses especially among patients with prior total knee replacement.…”

Section: Introductionmentioning

confidence: 99%

“…Imaging studies and biopsy are necessary to evaluate the mass and to exclude primary and metastatic bone and soft tissue tumors in these patients. Metastatic carcinomas to bone are rarely located around the knee joint; popliteal cysts, cellulitis, deep vein thrombosis and aneurysms can be evaluated using ultrasonography [ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Wear debris pseudotumor following total knee arthroplasty: a case report

et al. 2009

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IntroductionIn patients who have undergone a total joint replacement, any mass occurring in or adjacent to the joint needs thorough investigation and a wear debris-induced cyst should be suspected.Case presentationAn 81-year-old man presented with a painful and enlarging mass at the popliteal fossa and calf of his right knee. He had had a total right knee replacement seven years previously. Plain radiographs showed narrowing of the medial compartment. Magnetic resonance imaging showed a cystic lesion at the postero-medial aspect of the knee joint mimicking popliteal cyst or soft tissue sarcoma. Fine needle aspiration was non-diagnostic. A core-needle biopsy showed metallosis. Intraoperative findings revealed massive metallosis related to extensive polyethylene wear, delamination and deformation. Revision knee and patella arthroplasty was carried out after a thorough debridement of the knee joint.ConclusionLong-term follow-up is critical for patients with total joint replacement for early detection of occult polyethylene wear and prosthesis loosening. In these cases, revision arthroplasty may provide a satisfactory knee function.

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Section: Discussionmentioning

confidence: 99%

“…Metastatic carcinomas to bone are rarely located around the knee joint; popliteal cysts, cellulitis, deep vein thrombosis and aneurysms can be evaluated using ultrasonography [1-3]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Wear debris pseudotumor following total knee arthroplasty: a case report

et al. 2009

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Pathologic supracondylar fracture due to osteolytic pseudotumor of knee following cementless total knee replacement

Benevenia

Lee

Buechel

et al. 1998

J. Biomed. Mater. Res.

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Wear debris of polyethylene, polymethylmethacrylate, and metal have been recognized to be associated with foreign body reactions, osteolysis, and aseptic prosthetic loosening after joint replacement arthroplasty. Further, foreign body reaction due to the presence of extensive wear debris can cause aggressive granulomatous lesions and pathologic fracture. To our knowledge, there has been no previous report of pathologic fracture of the femur due to an agressive pseudotumor. This report describes a case of pathologic supracondylar fracture of the femur 6 years and 5 months after cementless total knee replacement arthroplasty. The fracture occurred through an aggressive expanding soft tissue mass that was a tumorlike lesion secondary to polyethylene wear debris. The lesion was associated with massive osteolysis around the femoral component of the total knee prosthesis.

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Metal wear-induced pseudotumour following an endoprosthetic knee replacement for Ewing sarcoma

et al. 2017

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Pseudotumours are well recognised as a complication of metal-on-metal hip arthroplasties and are thought to develop on the basis of an innate and adaptive immune response to cobalt-chrome (Co-Cr) wear particles. We report a case of a large pseudotumour that developed following a knee endoprosthetic replacement (EPR) undertaken for Ewing sarcoma. The lesion contained necrotic and degenerate connective tissue in which there were numerous scattered metal wear-containing macrophages, eosinophil polymorphs, lymphocytes, plasma cells and aseptic lymphocyte-dominated vascular-associated lesion-like lymphoid aggregates. Metal ion levels were elevated. No evidence of infection or tumour was noted and it was concluded that the lesion was most likely an inflammatory pseudotumour developing on the basis of an innate and adaptive immune response to components of Co-Cr metal wear derived from the knee EPR.

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Failure of a Polyethylene Total Knee Component Presenting as a Thigh Mass

Cited by 13 publications

References 0 publications

Wear debris pseudotumor following total knee arthroplasty: a case report

Wear debris pseudotumor following total knee arthroplasty: a case report

Pathologic supracondylar fracture due to osteolytic pseudotumor of knee following cementless total knee replacement

Metal wear-induced pseudotumour following an endoprosthetic knee replacement for Ewing sarcoma

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