title: Multilobulated popliteal cyst after a failed total knee arthroplasty.
abstract: Popliteal cyst is a rare finding after total knee arthroplasty (TKA), but when present, it might indicate a malfunction of the TKA related to generation of wear-particles, or loosening. We present a case of a multilobulated popliteal cyst developing in a patient 8 years after primary TKA. The cyst was associated with a mechanical prosthetic loosening. The primary complaint of the patient was pain in the posterior region of the knee. A two-stage procedure consisting of cyst excision at first, followed after 5 months by a revision TKA was performed. Intraoperatively, a darkish, multilobulated cyst with a well-defined thick wall filled with fluid containing polyethylene debris, communicating with the knee joint was found. After 3 years of follow-up, the patient was satisfied and walked without the support of a cane. The patient presented a satisfactory knee range of motion. Clinical, radiological and ultrasound investigations ruled out popliteal cyst recurrence. A dissecting popliteal cyst associated with a failed TKA should be excised because it contains polyethylene debris that constitutes an induced factor for prosthetic loosening. A two-stage procedure with quite a long time in-between, as presented in this paper, can be a useful alternative to manage such a problem, in particular in very old patients associated with other medical problems.
authors.affiliation: Department of Clinical Methodology and Surgical Technique, Orthopedics Section II, University of Bari, Bari, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Moretti
authors.forename: Vittorio
authors.initials: V
authors.lastname: Patella
authors.forename: Elyazid
authors.initials: E
authors.lastname: Mouhsine
authors.forename: Vito
authors.initials: V
authors.lastname: Pesce
authors.forename: Antonio
authors.initials: A
authors.lastname: Spinarelli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Garofalo
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011151:Popliteal Cyst / Q000000981:diagnostic imaging / Q000209:etiology*; D011475:Prosthesis Failure; D012086:Reoperation; D014057:Tomography, X-Ray Computed