Crystalline-Induced Arthropathy Following Total Knee Replacement
Adam M Green1, Anthony Gemayel1, Eric Silberg2
1Orthopedic Surgery, Beaumont Health, Dearborn, USA.
Cureus
|October 14, 2021
Summary
Gout after joint replacement can mimic infection, but joint fluid analysis confirms the diagnosis. Accurate diagnosis is crucial to avoid unnecessary implant removal.
Area of Science:
- Orthopedics
- Rheumatology
- Pathology
Background:
- Gout is uncommon following total joint replacement (TJR).
- Gout symptoms can mimic prosthetic joint infection (PJI), complicating diagnosis.
- Shared clinical and laboratory findings (leukocytosis, elevated ESR, CRP) between gout and PJI necessitate precise diagnostic methods.
Observation:
- This study reviews literature on gout in TJR patients.
- A case of bilateral gouty arthropathy post-total knee arthroplasty is presented.
Findings:
- Distinguishing gout from PJI relies on synovial fluid analysis.
- Microscopic identification of crystals (gout) or microorganisms (infection) is definitive.
Implications:
- Correctly diagnosing gout prevents misdiagnosis as PJI.
- Accurate diagnosis guides appropriate treatment, potentially avoiding needless implant revision surgery.
