A rare case of extensive diffuse nonpigmented villonodular synovitis as a cause of total knee arthroplasty failure Hacı Bayram Tosun, Abuzer Uludağ,

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Presentation transcript:

A rare case of extensive diffuse nonpigmented villonodular synovitis as a cause of total knee arthroplasty failure Hacı Bayram Tosun, Abuzer Uludağ, Sancar Serbest, Seyitali Gümüştaş, İbrahim Halil Erdoğdu International Journal of Surgery Case Reports Volume 5, Issue 7, Pages 419-423 (January 2014) DOI: 10.1016/j.ijscr.2014.04.031 Copyright © 2014 The Authors Terms and Conditions

Fig. 1 Pre-operative anteroposterior (a) and lateral (b) radiographs of the knee show loosening and osteolysis under the tibial component in the medial compartment. International Journal of Surgery Case Reports 2014 5, 419-423DOI: (10.1016/j.ijscr.2014.04.031) Copyright © 2014 The Authors Terms and Conditions

Fig. 2 Perfusion, blood pool, static phase, and anteroposterior whole-body images (three-phase bone imaging using technetium 99m methylene diphosphonate). Periprosthetic hyperperfusion, hyperemia, and increased periprosthetic activity are seen around the tibial component of a right total knee replacement. International Journal of Surgery Case Reports 2014 5, 419-423DOI: (10.1016/j.ijscr.2014.04.031) Copyright © 2014 The Authors Terms and Conditions

Fig. 3 Before (a) and after (b) synovectomy. Intra-operative photographs of the knee show diffuse papillae and nodules in the proliferating synovium, with yellow-brown areas (typical appearance of villonodular synovitis). International Journal of Surgery Case Reports 2014 5, 419-423DOI: (10.1016/j.ijscr.2014.04.031) Copyright © 2014 The Authors Terms and Conditions

Fig. 4 Post-operative anteroposterior (a) and lateral (b) radiographs of the knee show acceptable alignment and a well-fixed tibial component after revision total knee replacement. International Journal of Surgery Case Reports 2014 5, 419-423DOI: (10.1016/j.ijscr.2014.04.031) Copyright © 2014 The Authors Terms and Conditions

Fig. 5 (a) Photomicrograph of the specimen shows the synovial cell layer which is formed from different sized and shaped cellular areas surrounding the papillary villous structures (hematoxylin and eosin (H&E) staining, original magnification 40×). (b) Photomicrograph showing synovial proliferation with multinucleated giant cells, histiocytes, and a small number of lymphocytes under synovial cell structures surrounding the papillary villous (H&E, original magnification 40×). (c) Immunohistochemically there is diffuse infiltration of CD68-positive histiocytes (original magnification 20×). International Journal of Surgery Case Reports 2014 5, 419-423DOI: (10.1016/j.ijscr.2014.04.031) Copyright © 2014 The Authors Terms and Conditions