Chondrogenesis in the synovial tissue is associated with the onset of pseudogout after total knee arthroplasty

Sato, Ryosuke; Nakano, Shunji; Takasago, Tomoya; Nakamura, Masaru; Kashima, Masato; Chikawa, Takashi; Hamada, Daisuke; Goto, Tomohiro; Sairyo, Koichi

doi:10.1016/j.artd.2015.10.007

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…2 mesenchymal stem cells have chondrogenic potential, [18][19] which has implications in the pathogenesis of synovial chondromatosis. In another crystalline arthropathy, calcium pyrophosphate dehydrate crystals were synthesized mainly at the site of chondrogenesis after total knee arthroplasty, 20 supporting the hypothesis that cartilage damage or proteins and other macromolecules originating from the synovium or cartilage increase the risk for gouty attacks. 16…”

Section: Case Reportmentioning

confidence: 62%

Skeletal Complications With GNAS Mutation: An Unusual Case With Osteoma Cutis, Gout, and Synovial Chondromatosis in a Patient With Pseudopseudohypoparathyroidism

Rhyu

Bhat

2021

AACE Clinical Case Reports

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Section: Case Reportmentioning

confidence: 62%

Skeletal Complications With GNAS Mutation: An Unusual Case With Osteoma Cutis, Gout, and Synovial Chondromatosis in a Patient With Pseudopseudohypoparathyroidism

Rhyu

Bhat

2021

AACE Clinical Case Reports

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“…Even though the association between carpal tunnel syndrome and CPPD has been known for over 40 years, surgical release of the carpal ligament has always been associated with resolution of symptoms without any exacerbation. We therefore excluded any possible association with a minimally invasive surgery such as the liberation of the carpal canal and the acute event [ 23 – 25 ]. However, the global pandemic from COVID-19 has led to the development of several new vaccines that are inevitably associated with possible adverse reactions, which are emerging in recent times [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Calcium Pyrophosphate Crystal Arthritis of the Wrist Elicited by Anti-COVID-19 Vaccination After Carpal Tunnel Release

Perozzo

Punzi²,

Costa

et al. 2022

Am J Case Rep

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Patient: Male, 70-year-old Final Diagnosis: CPPD wrist arthritis Symptoms: Redness • edema of wrist Medication: — Clinical Procedure: — Specialty: Plastic Surgery Objective: Unusual clinical course Background: Calcium pyrophosphate dihydrate deposition disease includes a variety of clinical syndromes, including acute calcium pyrophosphate (CPP) crystal arthritis. Most patients with CPP crystal arthritis have a primary/idiopathic form presenting with severe pain, swelling, and stiffness. COVID-19 infection, which originated in China in December 2019, required extraordinary efforts to develop and test new vaccines to halt the pandemic. The Vaxzervria vaccine has shown excellent safety and efficacy in phase 3 trials with a mechanism based on the expression of the SARS-CoV-2 spike protein gene coding for the S-antigen, which stimulates the immune response. Case Report: We describe an acute event of crystal arthritis after a carpal tunnel syndrome release followed by administration of the second dose of anti-COVID-19 Vaccine Oxford-AstraZeneca (ChAdOx1 nCoV-19). Medical treatment resulted in full resolution of the symptoms in 2 weeks. Conclusions: Although most episodes of acute arthritis happen spontaneously, certain factors may trigger the acute CPP crystal arthritis such as intercurrent illnesses or surgeries. Although the association between carpal tunnel syndrome and CPP arthritis has been known for over 40 years, surgical release of the carpal ligament has always been associated with full resolution of symptoms. This is the first case report describing an exacerbation after carpal canal release, concomitant with the administration of the vaccine. According to our opinion, the vaccination associated with a prior surgery in the same anatomical site could have synergically triggered the arthritis flare-up, in a predisposed patient, with a mechanism still unknown.

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“…Crystal induced arthritis after TKA is not a new concept, and more articles are being published related to this topic. Sato describes the postoperative arthritis as a rare phenomenon caused by synthetization of crystals near the site of chondrogenesis in the synovial tissue [35]. Yahia et al reviewed seven cases of crystal induced arthritis after TKA and described five cases with calcium pyrophosphate crystals.…”

Section: Discussionmentioning

confidence: 99%

There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis

Willems

Rassir

Sierevelt

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Chondrocalcinosis is the radiographic appearance of calcium crystals in cartilage and other soft tissue. It is suggested that preoperative chondrocalcinosis predicts a worse outcome after total knee arthroplasty and it is unclear if chondrocalcinosis leads to more postoperative complications. This study aimed to compare function, pain, postoperative complications, postoperative signs of acute arthritis and revision rates between patients with and without chondrocalcinosis undergoing total knee arthroplasty for osteoarthritis. Methods In this retrospective cohort study performed in 2017, 408 knees in 392 patients (16 bilateral total knee arthroplasties) were included. None of the patients received additional synovectomy. PROMs were evaluated after 1 year (n = 294) and 5 years (n = 308). The follow‐up for clinical data was 5 years (n = 408). The range of final follow‐up was 57–84 months. All preoperative radiographs were scored for chondrocalcinosis and Oxford Knee Score, Knee Society Score and Algofunctional Index were used to assess outcome. All clinical records were screened for postoperative complications (excessive wound discharge, infection, loosening, PAO, stiffness), arthritis after surgery and reoperation or revision for any reason. Results Sixty‐three knees (15.4%) showed signs of chondrocalcinosis. Male gender, higher age and lower BMI were risk factors for chondrocalcinosis. No difference was found in Oxford Knee Score, Knee Society Score and Algofunctional Index, nor in postoperative complications, postoperative signs of acute arthritis and revision rate. Conclusion Patients with and without chondrocalcinosis have the same outcome after total knee arthroplasty related to pain, functionality, complications, arthritis and revision after surgery for end‐stage osteoarthritis. Chondrocalcinosis is not a contraindication for total knee arthroplasty and additional synovectomy is unnecessary. Level of evidence III.

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Chondrogenesis in the synovial tissue is associated with the onset of pseudogout after total knee arthroplasty

Cited by 8 publications

References 6 publications

Skeletal Complications With GNAS Mutation: An Unusual Case With Osteoma Cutis, Gout, and Synovial Chondromatosis in a Patient With Pseudopseudohypoparathyroidism

Skeletal Complications With GNAS Mutation: An Unusual Case With Osteoma Cutis, Gout, and Synovial Chondromatosis in a Patient With Pseudopseudohypoparathyroidism

Acute Calcium Pyrophosphate Crystal Arthritis of the Wrist Elicited by Anti-COVID-19 Vaccination After Carpal Tunnel Release

There is no difference in postoperative pain, function and complications in patients with chondrocalcinosis in the outcome of total knee arthroplasty for end-stage osteoarthritis

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