Aggressive granulomatosis complicating knee arthroplasty

Aggressive granulomatosis is a potentially devastating complication of joint-replacement surgery. This condition likely represents a foreign body reaction to particulate metal, methylmethacrylate or polyethylene. The authors describe a 51-year-old woman in whom aggressive granulomatosis developed after total knee arthroplasty. Plain radiographs over a 3-year period showed progressively expanding focal areas of bone loss. Revision arthroplasty was necessary to prevent pathologic fracture.