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Journal of Long-Term Effects of Medical Implants
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN Imprimir: 1050-6934
ISSN On-line: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2017021011
pages 13-20

PMMA Cement Allergy Misleading Total Knee Arthroplasty Infection

Panayiotis D. Megaloikonomos
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
Evanthia Mitsiokapa
P.N. Soukakos Orthopaedic Research and Education Center, Sylvia Ioannou Biomechanics and Gait Analysis Laboratory, Attikon University Hospital, First Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Dimitrios A. Flevas
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens Greece
Georgios Kakouratos
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens Greece
Georgios Kyrou
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens Greece
Panayiotis Koulouvaris
P.N. Soukakos Orthopaedic Research and Education Center, Sylvia Ioannou Biomechanics and Gait Analysis Laboratory, Attikon University Hospital, First Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Andreas F. Mavrogenis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

RESUMO

Arthroscopic and prosthetic hip and knee joint infection are uncommon; however, devastating complications in adult reconstruction surgery. An acute onset of pain combined with effusion, erythema, warmth and fever are the typical signs of early infection. Hypersensitivity or allergic reactions to arthroplasty components, concerning mainly metal-to-metal bearings and metal-on-plastic total knee arthroplasties have also been reported. Inflammation associated with allergic reaction to any of these materials (metallic and/or acrylic bone cement) can plausibly cause a number of similar manifestations to infection such as loosening, instability, stiffness, arthrofibrosis, swelling, warmth, and pain. This article presents a patient without known polymethylmethacrylate (PMMA) bone cement allergy who experienced a prosthetic joint infection after a cemented total knee arthroplasty. The diagnosis of infection was misled by the wrong timing of cultures with respect to antibiotics cessation, and the documentation of PMMA cement allergy with allergiologic examination and patch testing.


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