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Poster: 109Severe Persistent Synovitis After Cobalt Chromium Total KneeArthroplasty Requiring Revision Surgery Report of Five Patients*Raman Thakur - William Harvey Hospital - Ashford, UKMichael McGraw - Howard University School of medicine - Washington, USAMathais Bostrum - Hospital for Special Surgery - New York, USAJose Rodriguez - Lenox Hill Hospital - New York, USAMichael Parks - Hospital for Special Surgery - New York, USA*Email: doc_thakur@hotmail.comImplant related hypersensitivity is a well-established cause of failure after total hip arthroplasty,but a rare complication after total knee replacement. It remains a relatively unpredictable andpoorly understood cause of failure of an implant.We present a report of five patients who presented with persistent hypertrophic synovitis(Figure 1 and 2) after total knee replacement using a cobalt chrome component. Extensivepreoperative and intraoperative attempts ruled out infection as a cause of symptoms. The kneeshad good ligamentous balance and were well aligned and fixed.The clinical condition improved after revision to a zirconium femoral and titanium metalbacked tibial components. Intraoperative histopathology revealed thickened synovium with apredominantly monocellular (lymphocytic or histiocytic) response(Fig. 3).Where infection and instability have been excluded as a cause of persistent pain and swelling,consideration should be given to allergy as a cause of failure in primary knee replacementsurgery.FiguresPoster: 110file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]