Adaptive Immune Response Associated with a Zirconium-Containing, Cemented, Total Knee Arthroplasty: A Case Report

T. David Tarity, Jonathan M. Vigdorchik, Geoffrey H. Westrich, Alejandro Gonzalez Della Valle, Paola Cerrito, Elexis C. Baral, Timothy G. Bromage, Thomas W. Bauer

Research output: Contribution to journalArticlepeer-review

Abstract

CASE: A 69-year-old woman underwent revision total knee arthroplasty for patellar component aseptic loosening. The periprosthetic tissue demonstrated histologic features of an adaptive immune response (aseptic lymphocyte-dominant vasculitis-associated lesion [ALVAL]). No particles of corrosion debris were identified. The inflammation seemed to be associated with zirconium oxide (ZrO2) particles added as a bone cement radio-opacifier. CONCLUSION: The factors responsible for the adaptive immune response cannot be determined with certainty; however, this is the first reported case of ALVAL associated with ZrO2-containing bone cement. Previous reports describing ALVAL around failed total knee prostheses have not included observations about the type of contrast material added to cement.

Original languageEnglish (US)
JournalJBJS Case Connector
Volume11
Issue number3
DOIs
StatePublished - Aug 27 2021

ASJC Scopus subject areas

  • Medicine(all)

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