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Pathologic fractures: a complication of microparticulate synovitis
C A Peimer1, J Taleisnik, F S Sherwin
1Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York.
The Journal of Hand Surgery
|September 1, 1991
Summary
Late pathologic fractures can occur after silicone wrist and trapezial arthroplasty due to untreated microparticulate synovitis from prosthetic wear. Continuous patient follow-up is crucial for early detection of these severe complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Rheumatology
Background:
- Silicone arthroplasty is a common procedure for wrist and trapezial joint degeneration.
- While generally successful, late complications associated with silicone implants are a concern.
- Microparticulate synovitis, resulting from prosthetic wear, is a known potential sequela.
Observation:
- Seven adult patients presented with pathologic fractures an average of 5 years post-silicone wrist or trapezial arthroplasty.
- All patients initially experienced good outcomes before developing late complications.
- Radiographic evidence revealed generalized implant and intramedullary bone destruction, including endosteal scalloping and cortical resorption.
Findings:
- The observed bone destruction represents the end stage of untreated microparticulate synovitis.
- These radiographic changes, indicative of prosthetic wear, may be subtler than those seen with other carpal implant degenerations.
- Pathologic fracture is a significant late complication following silicone arthroplasty.
Implications:
- Continuous and careful patient follow-up is essential after silicone implant arthroplasty.
- Patients must be informed about potential long-term risks, such as pathologic fracture.
- This highlights the importance of monitoring for complications related to biomaterial wear in orthopedic implants.