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Related Experiment Videos

Pseudogout after total knee arthroplasty.

P D Sonsale1, M R Philipson

  • 1Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, London Road, Derby, United Kingdom.

The Journal of Arthroplasty
|February 6, 2007
PubMed
Summary

A patient developed knee joint inflammation 9 years post-total knee replacement, later identified as calcium pyrophosphate dihydrate crystal deposition disease. This rare condition resolved with conservative treatment, with no recurrence over 8 years.

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Crystal Arthropathies

Background:

  • Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
  • Septic arthritis is a known complication of TKA, requiring prompt diagnosis and treatment.
  • Crystal-induced arthropathies can mimic septic arthritis, posing diagnostic challenges.

Observation:

  • A patient presented with acute knee pain and swelling 9 years after TKA.
  • Aspiration revealed thick, purulent fluid containing calcium pyrophosphate dihydrate (CPPD) crystals.
  • No microorganisms were identified in the synovial fluid cultures.

Findings:

  • The patient was diagnosed with acute calcium pyrophosphate dihydrate arthropathy (pseudogout) of the knee.
  • The condition presented 9 years after total knee arthroplasty, a previously unreported occurrence.

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  • Symptoms resolved rapidly with aspiration, rest, and nonsteroidal anti-inflammatory drugs.

    • Implications:

    • This case highlights the importance of considering crystal arthropathies in the differential diagnosis of joint effusions after TKA.
    • CPPD crystal deposition disease can occur years after TKA and mimic septic arthritis.
    • Early diagnosis and management of CPPD arthropathy can lead to favorable outcomes.