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Prosthesis-induced synovitis simulating villonodular synovitis
1Rheumatology Section, W.S. Middleton Memorial VA Hospital, Madison.
Wisconsin Medical Journal
|April 1, 1991
Summary
Prosthetic synovitis, a rare complication of total knee arthroplasty, can occur years after surgery. This case highlights polyethylene particles causing nonpigmented villonodular synovitis in a patient with a knee prosthesis.
Area of Science:
- Orthopedic Surgery
- Pathology
- Biomaterials Science
Background:
- Prosthetic arthroplasty is a common procedure for managing arthritis.
- Prosthetic failures can result from loosening, infection, subluxation, or fracture.
Observation:
- A 65-year-old male patient developed complications 5 years after a metal-polyethylene total knee arthroplasty.
- Diagnostic imaging revealed nodular synovial filling defects via double contrast arthrography.
Findings:
- Arthrotomy and histological examination confirmed nonpigmented villonodular synovitis (VS).
- Microscopic analysis identified giant cells and polyethylene particles within the synovium, indicating a reaction to implant debris.
Implications:
- This case underscores prosthetic synovitis as a potential long-term complication of total knee arthroplasty.
- Understanding the role of polyethylene wear particles is crucial for improving prosthetic longevity and patient outcomes.