{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:21Z","timestamp":1787755641203,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>An 87-year-old woman presented with a popliteal skin lesion due to polyethylene wear 13 years following a left total knee arthroplasty. Excisional biopsy through a posterior approach was performed. Histology showed inflammation with granulomas and birefringent foreign body particles in the skin. Cultures remained negative, and revision knee arthroplasty was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A popliteal skin lesion due to polyethylene wear disease in total knee arthroplasty has not previously been described. Patients with an atypical inflammation of the skin with an underlying joint implant should be referred to an orthopaedic surgeon, and dermal biopsies should be checked for birefringent material.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level V.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.18.00484","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T14:39:56Z","timestamp":1572878396000},"page":"e0484-e0484","source":"Crossref","is-referenced-by-count":0,"title":["Popliteal Skin Lesion due to Wear Disease in Total Knee Arthroplasty"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-1205","authenticated-orcid":false,"given":"Steven C.","family":"van Veen","sequence":"first","affiliation":[{"name":"Orthopedic Surgery, Martini Hospital Groningen, Groningen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3357-6650","authenticated-orcid":false,"given":"Maarten R.","family":"Huizinga","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Martini Hospital Groningen, Groningen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-3769","authenticated-orcid":false,"given":"Jos J.A.M.","family":"van Raaij","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Martini Hospital Groningen, Groningen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019]]},"reference":[{"issue":"9","key":"bib2-20230811","doi-asserted-by":"crossref","first-page":"8046","DOI":"10.1016\/j.actbio.2013.05.005","article-title":"Osteolysis around total knee arthroplasty: a review of pathogenetic mechanisms","volume":"9","author":"Gallo","year":"2013","journal-title":"Acta Biomater."},{"issue":"6","key":"bib3-20230811","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/S0883-5403(03)00255-9","article-title":"\u201cBackside\u201d polyethylene deformation in total knee arthroplasty","volume":"18","author":"Akisue","year":"2003","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib4-20230811","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1002\/(SICI)1097-4636(199824)43:4<473::AID-JBM16>3.0.CO;2-9","article-title":"Pathologic supracondylar fracture due to osteolytic pseudotumor of knee following cementless total knee replacement","volume":"43","author":"Benevenia","year":"1998","journal-title":"J Biomed Mater Res."},{"issue":"2","key":"bib5-20230811","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S0883-5403(99)90120-1","article-title":"Relationship between wear debris particles and polyethylene surface damage in primary total knee arthroplasty","volume":"14","author":"Hirakawa","year":"1999","journal-title":"J Arthroplasty."},{"key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"9304","DOI":"10.1186\/1752-1947-3-9304","article-title":"Wear debris pseudotumor following total knee arthroplasty: a case report","volume":"3","author":"Mavrogenis","year":"2009","journal-title":"J Med Case Rep."},{"issue":"1","key":"bib7-20230811","doi-asserted-by":"crossref","first-page":"115","DOI":"10.2106\/00004623-199901000-00016","article-title":"Wear in total hip and knee replacements","volume":"81","author":"Schmalzried","year":"1999","journal-title":"J Bone Joint Surg Am."},{"key":"bib8-20230811","first-page":"205","article-title":"Polyethylene wear and osteolysis following total knee replacement","volume":"46","author":"Ayers","year":"1997","journal-title":"Instr Course Lect."},{"issue":"2","key":"bib9-20230811","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5312\/wjo.v6.i2.172","article-title":"Biological response to prosthetic debris","volume":"6","author":"Bitar","year":"2015","journal-title":"World J Orthop."},{"issue":"4","key":"bib10-20230811","doi-asserted-by":"crossref","first-page":"212","DOI":"10.5435\/00124635-199407000-00004","article-title":"Wear debris in total joint replacements","volume":"2","author":"Jacobs","year":"1994","journal-title":"J Am Acad Orthop Surg."},{"issue":"21","key":"bib11-20230811","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.1016\/S0142-9612(03)00246-1","article-title":"Flow cytometric technique for the detection of phagocytosed wear particles in patients with total joint arthroplasty","volume":"24","author":"Niki","year":"2003","journal-title":"Biomaterials."},{"issue":"suppl 1","key":"bib12-20230811","first-page":"S47","article-title":"Adverse soft-tissue reactions around non-metal-on-metal total hip arthroplasty\u2014a systematic review of the literature","volume":"69","author":"Carli","year":"2011","journal-title":"Bull NYU Hosp Joint Dis."},{"issue":"333","key":"bib13-20230811","first-page":"4","article-title":"Tissue reactions to plastic and metallic wear products of joint endoprostheses","author":"Willert","year":"1996","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib14-20230811","first-page":"E113","article-title":"Massive baker cyst resulting in tibial nerve compression neuropathy secondary to polyethylene wear disease","volume":"44","author":"Moyad","year":"2015","journal-title":"Am J Orthop."},{"issue":"2","key":"bib15-20230811","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2310\/6620.2011.10055","article-title":"Cutaneous and systemic hypersensitivity reactions to metallic implants","volume":"22","author":"Basko-Plluska","year":"2011","journal-title":"Dermatitis."},{"issue":"4","key":"bib16-20230811","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/j.0105-1873.2006.0775o.x","article-title":"Dermatitis on the knee following knee replacement: a minority of cases show contact allergy to chromate, cobalt or nickel but a causal association is unproven","volume":"54","author":"Verma","year":"2006","journal-title":"Contact Derm."},{"issue":"2","key":"bib17-20230811","doi-asserted-by":"crossref","first-page":"106","DOI":"10.5435\/JAAOS-D-14-00290","article-title":"Metal hypersensitivity and total knee arthroplasty","volume":"24","author":"Lachiewicz","year":"2016","journal-title":"J Am Acad Orthop Surg."},{"issue":"4","key":"bib18-20230811","doi-asserted-by":"crossref","first-page":"665.e13","DOI":"10.1016\/j.arth.2010.06.002","article-title":"Dermatitis associated with chromium following total knee arthroplasty","volume":"26","author":"Gao","year":"2011 Jun","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib19-20230811","first-page":"220","article-title":"Allergic eczemas from metallic foreign bodies","volume":"52","author":"Foussereau","year":"1966","journal-title":"Trans St Johns Hosp Dermatol Soc."},{"issue":"2","key":"bib20-20230811","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s00132-008-1195-7","article-title":"Allergy to bone cement components [in German]","volume":"37","author":"Thomas","year":"2008","journal-title":"Orthopade."},{"issue":"1S","key":"bib21-20230811","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1016\/j.otsr.2016.06.021","article-title":"Allergies in orthopaedic and trauma surgery","volume":"103","author":"Lohmann","year":"2017","journal-title":"Orthop Traumatol Surg Res."},{"issue":"2","key":"bib22-20230811","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00264-015-3001-6","article-title":"Allergic reactions in arthroplasty: myth or serious problem?","volume":"40","author":"Guenther","year":"2016","journal-title":"Int Orthop."},{"issue":"4","key":"bib23-20230811","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1302\/0301-620X.98B4.36767","article-title":"Allergy in total knee arthroplasty: a review of the facts","volume":"98-B","author":"Middleton","year":"2016","journal-title":"Bone Joint J"},{"issue":"4","key":"bib24-20230811","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1600-0536.2009.01599.x","article-title":"Cobalt allergy and suspected aseptic lymphocyte-dominated vascular-associated lesion following total hip arthroplasty","volume":"61","author":"Jensen","year":"2009","journal-title":"Contact Derm"},{"issue":"12","key":"bib25-20230811","doi-asserted-by":"crossref","first-page":"3699","DOI":"10.1007\/s11999-014-3725-4","article-title":"How has the introduction of new bearing surfaces altered the biological reactions to byproducts of wear and modularity?","volume":"472","author":"Wooley","year":"2014","journal-title":"Clin Orthop Relat Res."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.18.00484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:37Z","timestamp":1787751937000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.18.00484"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.18.00484","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]}}}