Periostealpseudotumorincomplextotalkneearthroplastyresemblinganeoplasticprocess
摘要: Thiscasereportdescribesindetailanerosivedistaldiaphysealpseudotumorthatoccurred6yearsafteracomplexendoprosthetichingetotalkneearthroplasty(TKA).AfemalepatienthadconversionofakneefusiontoanendoprosthetichingeTKAattheageof62.Atherscheduled6-yearfollow-up,shepresentedwithmilddistalthighpainandradiographsshowinga6-7cmerosivelyticdiaphyseallesionthatlookedverysuspiciousforaneoplasticprocess.Anenblocresectionofthedistalfemurandfemoralendoprosthesiswasperformed.Histologicreviewshowedthemasstobeapseudotumorwiththeweardebrisemanatingfromwithinthefemoralcanalduetodistalstemloosening.Wededucethatmechanizedstemabrasioncreatedmicroscopictitaniumalloyparticlesthatescapedviaasmalldiaphysealcrackandstimulatedaninflammatoryresponseresultinginaperiostealerosivepseudotumor.Themainlessonofthisreportisthat,inthefaceofajointreplacementsurgeryoftheknee,pseudotumorformationisamorelikelydiagnosisthananeoplasticprocesswhenencounteringanexpandingbonymass.Thus,abiopsypriortoenblocresection,wouldbeourrecommendedcourseofactionanytimeasuspiciousmassisencounteredclosetoaTKA. ...
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