Bilateral pseudogout 8 years after bilateral total knee arthroplasty

Area of Science:

• Orthopedics
• Rheumatology
• Crystal Arthropathies

Background:

• Crystal arthropathy, including gout and pseudogout, is a recognized complication following knee replacement.
• Literature on these conditions post-total knee arthroplasty (TKA) and partial knee arthroplasty is limited.
• This article reviews existing literature and presents a unique case study.

Observation:

• A patient developed bilateral pseudogout 8 years after undergoing bilateral total knee arthroplasty (TKA).
• The presentation was characterized by sudden onset of pain and effusion, mimicking a late-onset septic joint.
• This is the first reported case of bilateral pseudogout following bilateral TKA.

Findings:

• The patient's pseudogout was successfully managed with a combination of surgical intervention and medical treatment.
• Treatment included arthrotomy, debridement, synovectomy, polyethylene insert exchange, oral steroids, and NSAIDs.
• Prompt diagnosis and appropriate management are crucial for favorable outcomes.

Implications:

• Pseudogout should be considered in the differential diagnosis of acute joint pain and effusion in patients with a history of knee replacement.
• This case underscores the importance of recognizing and managing crystal arthropathy in the context of prosthetic joints.
• Further research is needed to understand the pathogenesis and optimal management strategies for crystal arthropathy after knee arthroplasty.