Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection
In this report, we present the case of an 80-year-old female with pain located over the tip of her cemented tibial stem in a revision hinge total knee arthroplasty with localized osteolysis that looked suspicious for infection. A thorough workup was negative for infection. We postulate that the oste...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-04-01
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| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344122000346 |
| _version_ | 1818048718681669632 |
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| author | Scott Galey, MD Chad Ishmael, MD Stephen Zoller, MD Matthew Dipane, BA Edward McPherson, MD |
| author_facet | Scott Galey, MD Chad Ishmael, MD Stephen Zoller, MD Matthew Dipane, BA Edward McPherson, MD |
| author_sort | Scott Galey, MD |
| collection | DOAJ |
| description | In this report, we present the case of an 80-year-old female with pain located over the tip of her cemented tibial stem in a revision hinge total knee arthroplasty with localized osteolysis that looked suspicious for infection. A thorough workup was negative for infection. We postulate that the osteolysis at the end of her tibial stem was initiated by a modulus of elasticity mismatch at the stem tip, which generated a focal area of increased sagittal bone bending and microparticle generation. She was treated with lesional exploration, debridement, synthetic bone grafting, and tibial plating to distribute stress loads away from the tibial stem tip. Histologic analysis identified no organisms or neoplasm. Her pain ultimately resolved, and the patient returned to her customary activities. |
| first_indexed | 2024-12-10T10:26:08Z |
| format | Article |
| id | doaj.art-ddc346e9d7104465b81f6de945e91e93 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-10T10:26:08Z |
| publishDate | 2022-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-ddc346e9d7104465b81f6de945e91e932022-12-22T01:52:43ZengElsevierArthroplasty Today2352-34412022-04-0114116120Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking InfectionScott Galey, MD0Chad Ishmael, MD1Stephen Zoller, MD2Matthew Dipane, BA3Edward McPherson, MD4Corresponding author. Department of Orthopaedic Surgery, UCLA, 1929 6th St Apt 1, Santa Monica, CA 90405, USA. Tel.: +1 301 467 2244.; Department of Orthopaedic Surgery, UCLA, Los Angeles, CA, USADepartment of Orthopaedic Surgery, UCLA, Los Angeles, CA, USADepartment of Orthopaedic Surgery, UCLA, Los Angeles, CA, USADepartment of Orthopaedic Surgery, UCLA, Los Angeles, CA, USADepartment of Orthopaedic Surgery, UCLA, Los Angeles, CA, USAIn this report, we present the case of an 80-year-old female with pain located over the tip of her cemented tibial stem in a revision hinge total knee arthroplasty with localized osteolysis that looked suspicious for infection. A thorough workup was negative for infection. We postulate that the osteolysis at the end of her tibial stem was initiated by a modulus of elasticity mismatch at the stem tip, which generated a focal area of increased sagittal bone bending and microparticle generation. She was treated with lesional exploration, debridement, synthetic bone grafting, and tibial plating to distribute stress loads away from the tibial stem tip. Histologic analysis identified no organisms or neoplasm. Her pain ultimately resolved, and the patient returned to her customary activities.http://www.sciencedirect.com/science/article/pii/S2352344122000346Aseptic osteolysisStem tipEnd of stem painModulus mismatchTotal knee arthroplastyRevision |
| spellingShingle | Scott Galey, MD Chad Ishmael, MD Stephen Zoller, MD Matthew Dipane, BA Edward McPherson, MD Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection Arthroplasty Today Aseptic osteolysis Stem tip End of stem pain Modulus mismatch Total knee arthroplasty Revision |
| title | Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection |
| title_full | Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection |
| title_fullStr | Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection |
| title_full_unstemmed | Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection |
| title_short | Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection |
| title_sort | stress induced aseptic osteolysis of the mid tibia in a revision hinged total knee arthroplasty mimicking infection |
| topic | Aseptic osteolysis Stem tip End of stem pain Modulus mismatch Total knee arthroplasty Revision |
| url | http://www.sciencedirect.com/science/article/pii/S2352344122000346 |
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