Malignant fibrous histiocytoma of the distal femur after an arthroscopic anterior cruciate ligament reconstruction: A case report and a review of the literature.
BACKGROUND
Malignant degeneration in association with orthopaedic implants is a known but rare complication. To our knowledge, no case of osseous malignant fibrous histiocytoma after anterior cruciate ligament reconstruction is reported in the literature.


METHODS
We report a 29-year-old male Turkish patient who presented with severe pain in the operated knee joint 40 months after arthroscopic anterior cruciate ligament reconstruction. X-ray and MR imaging showed a large destructive tumor in the medial femoral condyle. Biopsy determined a malignant fibrous histiocytoma. After neoadjuvant chemotherapy, wide tumor resection and distal femur reconstruction with a silver-coated non-cemented tumor knee joint prosthesis was performed. Adjuvant chemotherapy was continued according to the EURAMOS 1 protocol.


CONCLUSIONS
Though secondary malignant degeneration after orthopaedic implants or prostheses is not very likely, the attending physician should take this into consideration, especially if symptoms worsen severely over a short period of time.
Department of Orthopaedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg, Germany. efet@med.uni-marburg.de
Turgay
T
Efe
Thomas J
TJ
Heyse
Markus D
MD
Schofer
Susanne
S
Fuchs-Winkelmann
Peter
P
Rexin
Jan
J
Schmitt
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D001182:Arthroscopy / Q000009:adverse effects*; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D005266:Femoral Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D051677:Histiocytoma, Malignant Fibrous / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020360:Neoadjuvant Therapy; D010146:Pain / Q000209:etiology; D012086:Reoperation; D012421:Rupture; D013709:Tendon Transfer / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome