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Orthofeed 2022, Edition 1                                                                            06


 Postoperative Observations 7  five  years,  biennial  for  years  6-10,  and  then   Macrophages, Foreign Body Giant Cells and Their

 Excellent   placement   of   a   left   knee   either annual  or  biennial  for  the years   Response to Implantable Biomaterials. Materials (Basel).

 arthroplasty as confirmed by X-ray scans.  thereafter. 8      2015;8(9):5671-5701. Published 2015 Aug 28.
                                                              doi:10.3390/ma8095269
 No  postoperative complications  reported in
 patient.  The present case report highlights the             7) Cantrell CK, Patel HA, Stroud WR, et al. A Case Report

 Discharge: Day 2 postoperatively  importance of long-term follow up, especially   of Revision Total Knee Arthroplasty After 17 Years: All
           in younger patient population  for early           Grown Up, What Happens When Implants Mature?

 Follow up after two weeks 7   diagnosis of implant failure and to avoid more   Cureus. 2018;10(6):e2797. doi:10.7759/cureus.2797
 Pain was well controlled   complex  revision  surgeries  that  are  highly

 Physical therapy was well followed  laborious and costly for the patients. 7  8) Teeny SM, York SC, Mesko JW, Rea RE. Long-term
 Gross visual inspection    X-ray  scan  showed  left  knee  arthroplasty  to   follow-up care recommendations after total hip and knee

 Long-term reaction at bone-cement interface   be in  correct  position  with  no  evidence of   References:  arthroplasty: results of the American Association of Hip
 led to engulfing of cement and direct ingrowth   hardware malfunction or loosening.  and Knee Surgeons' member survey. J Arthroplasty.

 of bone to implant.    1) Singh J, Politis A, Loucks L, Hedden DR, Bohm ER.   2003;18(8):954-962. doi:10.1016/j.arth.2003.09.001
 7
 Outcome  Trends in revision hip and knee arthroplasty observations

 Histological assessment    The patient  provided  positive review on her   after implementation of a regional joint replacement
 Papillary  synovial  proliferation  in  agreement   new prosthesis. 7  registry. Can J Surg. 2016;59(5):304-310.
        doi:10.1503/cjs.002916
 with patient’s history of osteoarthritis. 7
 Multiple  FBGCs  formed  by  fused    Operative pearls for surgery  2) Bayliss LE, Culliford D, Monk AP, et al. The effect of

 macrophages were observed in response to   The  underlying mechanism of FBGCs   patient age at intervention on risk of implant revision after
 polarizable foreign material. 7   reaction  on  prostheses  and  hydroxyapatite   total replacement of the hip or knee: a population-based

 cement remains elusive and requires further   cohort study Lancet. 2017;389(10077):1424-1430.
 Diagnosis and procedure  doi:10.1016/S0140-6736(17)30059-4
 research.
 Chronic inflammation and FBGC reaction due

 to  orthopaedic  implants  were  confirmed   3) Clohisy JC, Kamath GV, Byrd GD, Steger-May K, Wright
 Patients may remain asymptomatic for FBGC
 (Figure 2 a, b). 7  RW. Patient compliance with clinical follow-up after total
 reactions in response to implants for a long   joint arthroplasty. J Bone Joint Surg Am.
 Component  removal and revision  of knee
 period, and  by the time symptoms  arise,   2008;90(9):1848-1854. doi:10.2106/JBJS.G.00856
 components were performed as per standard
 already  an  extensive  damage  to  the
 technique. 7
 periprosthetic bone may have occurred.    4) Neale SD, Athanasou NA. Cytokine receptor profile of
 2
 Therefore, clinical  symptoms  should be   arthroplasty macrophages, foreign body giant cells and

 preceded  by radiologic  assessment  of   mature osteoclasts. Acta Orthop Scand.
 implant failure. 2  1999;70(5):452-458. doi:10.3109/17453679909000980
 Surgery

 A  medial  parapatellar  arthrotomy was   components (Figure 1a). 7   Future considerations  5) Brodbeck WG, Anderson JM. Giant cell formation and

 performed ,   The  femoral  component  showed  bone   The American Association  of Hip and Knee   function. Curr Opin Hematol. 2009;16(1):53-57.
 7
 Extensive  osteophytes  around  the  patella   ingrowth,  which had  encased the patella   Surgeons (AAHKS)  recommends to pursue   doi:10.1097/MOH.0b013e32831ac52e

 were  removed  and  a  medial  release  was   (Figure 1b). 7   an annual radiological follow up for the first   6) Sheikh Z, Brooks PJ, Barzilay O, Fine N, Glogauer M.
 performed, to facilitate removal of previous
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