title: A rare case of pseudotumor formation associated with methyl methacrylate hypersensitivity in a patient following cemented total knee arthroplasty.
abstract: Hypersensitivity to orthopedic implant materials has been well documented with potential catastrophic consequences if not addressed pre-operatively. The spectrum of reactions is wide, from mild non-specific pain with localized erythema to severe periprosthetic inflammatory destruction and pseudotumor formation. It is therefore essential to identify patients who have or are at risk for implant-associated hypersensitivity. Although metal sensitivity is commonly cited as the cause of these reactions, methyl methacrylate (MMA) has rarely been implicated. To the best of our knowledge, methyl methacrylate-associated pseudotumor formation has not yet been described. The following is a case report of a 68-year-old female who, after undergoing a routine cemented right total knee arthroplasty, developed a painless, enlarging mass during a 13-year period. This mass was found to be a pseudotumor in association with methyl methacrylate hypersensitivity. A review of pseudotumor pathogenesis, methyl methacrylate hypersensitivity, and preoperative preventative care is discussed.
authors.affiliation: Department of Orthopaedics, Long Island Jewish Medical Center, Hofstra Northwell Health, New Hyde Park, 11040, NY, USA. shachar.kenan@gmail.com.
authors.forename: Shachar
authors.identifier: http://orcid.org/0000-0002-7292-0629
authors.initials: S
authors.lastname: Kenan
authors.affiliation: Musculoskeletal Pathology, Department of Pathology, Long Island Jewish Medical Center, Hofstra Northwell Health, New Hyde Park, 11040, NY, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Kahn
authors.affiliation: Department of Musculoskeletal Radiology, Albert Einstein College of Medicine, New York, 10461, NY, USA.
authors.forename: Noga
authors.initials: N
authors.lastname: Haramati
authors.affiliation: Department of Orthopaedics, Long Island Jewish Medical Center, Hofstra Northwell Health, New Hyde Park, 11040, NY, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kenan
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006104:Granuloma, Plasma Cell / Q000139:chemically induced*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D008670:Metals; D020366:Methylmethacrylate / Q000009:adverse effects*
chemical_list: D008670:Metals; D020366:Methylmethacrylate
keywords: Allergy; Hypersensitivity; Methyl methacrylate; Pseudotumor; Total knee arthroplasty