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The Journal of Bone and Joint Surgery 78:588-93 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Lymphadenopathy Associated with Total Joint Prostheses. A Report of Two Cases and a Review of the Literature*

ERIC B. BENZ, B.A.{dagger}, BRADFORD SHERBURNE, M.D.{ddagger}, JIHAD E. HAYEK, M.D.{ddagger}, KENNETH H. FALCHUK, M.D.§, CLEMENT B. SLEDGE, M.D.§ and MYRON SPECTOR, PH.D.§, BOSTON, MASSACHUSETTS

Investigation performed at the Department of Pathology, Deaconess Hospital, and the Departments of Medicine and Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston


   Introduction
 
Local and regional lymphadenopathy that is caused by wear particles released from a joint-replacement prosthesis is becoming increasingly recognized as a possible complication of arthroplasty. Particles generated by the mechanical wear of a prosthesis can leave the site of the implant through lymphatic vessels and become engulfed by macrophages within the local and regional lymph nodes. The accumulation of cells containing particles causes the enlargement of a lymph node and the characteristic histological appearance of sinus histiocytosis8. The distention and prominence of the lymphatic sinuses are due to the presence of large numbers of either histiocytes derived from the cells that line the sinuses or macrophages derived from circulating monocytes. Multinucleated giant cells, resulting from the fusion of macrophages or histiocytes, might also be found in the dilated sinuses.

The accumulation of polyethylene, polymethylmethacrylate, and metal particles in the lymph nodes draining joints that have been replaced with a . . . [Full Text of this Article]


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