title: Pathologic supracondylar fracture due to osteolytic pseudotumor of knee following cementless total knee replacement.
abstract: Wear debris of polyethylene, polymethylmethacrylate, and metal have been recognized to be associated with foreign body reactions, osteolysis, and aseptic prosthetic loosening after joint replacement arthroplasty. Further, foreign body reaction due to the presence of extensive wear debris can cause aggressive granulomatous lesions and pathologic fracture. To our knowledge, there has been no previous report of pathologic fracture of the femur due to an agressive pseudotumor. This report describes a case of pathologic supracondylar fracture of the femur 6 years and 5 months after cementless total knee replacement arthroplasty. The fracture occurred through an aggressive expanding soft tissue mass that was a tumorlike lesion secondary to polyethylene wear debris. The lesion was associated with massive osteolysis around the femoral component of the total knee prosthesis.
authors.affiliation: Department of Orthopaedics, New Jersey Medical School, Newark 07013, USA.
authors.forename: J
authors.initials: J
authors.lastname: Benevenia
authors.forename: F Y
authors.initials: FY
authors.lastname: Lee
authors.forename: F
authors.initials: F
authors.lastname: Buechel
authors.forename: J R
authors.initials: JR
authors.lastname: Parsons
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001672:Biocompatible Materials / Q000009:adverse effects; D005269:Femur / Q000293:injuries / Q000473:pathology; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D006104:Granuloma, Plasma Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011095:Polyethylenes / Q000009:adverse effects; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011859:Radiography; D012086:Reoperation
chemical_list: D001672:Biocompatible Materials; D011095:Polyethylenes; D019904:Polymethyl Methacrylate