Late hemorrhagic pseudoseptic arthritis encountered during total knee arthroplasty due to hyaluronic acid viscosupplementation Jeremy M. Korsh, MD, William.

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Late hemorrhagic pseudoseptic arthritis encountered during total knee arthroplasty due to hyaluronic acid viscosupplementation Jeremy M. Korsh, MD, William.

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Presentation transcript:

Late hemorrhagic pseudoseptic arthritis encountered during total knee arthroplasty due to hyaluronic acid viscosupplementation Jeremy M. Korsh, MD, William Paul Bassett, MD, Donald R. Polakoff, MD Arthroplasty Today Volume 2, Issue 4, Pages 165-169 (December 2016) DOI: 10.1016/j.artd.2016.08.006 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Preoperative radiographs. Preoperative anteroposterior (AP), lateral, and merchant weight bearing views of the right knee showing severe tricompartmental arthritis. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 2 Intraoperative findings. Intraoperative photo showing marked synovitis and areas of blackened articular cartilage. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Postoperative radiographs. AP and lateral views of the right knee after TKA. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Inflamed synovium. Hematoxylin and eosin (H&E) stain, ×20 magnification: Proliferative synovium with brown pigment demonstrating hemosiderin in stroma. (Brown pigment on lower left of image is marking ink; pathology is on the lower right.) Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 5 Iron in synovium. Prussian blue stain, ×20 magnification: blue pigment showing iron in synovium. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 6 Iron in cartilage. Prussian blue stain, ×20 magnification: blue pigment showing iron in cartilage. Also, there is thinning of the cartilage with clefts and fibrillation representing osteoarthritis. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions

Figure 7 Foreign body material. Hematoxylin and eosin stain, ×20 magnification: foreign body material seen within synovial giant cells. Arthroplasty Today 2016 2, 165-169DOI: (10.1016/j.artd.2016.08.006) Copyright © 2016 The Authors Terms and Conditions