{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:29:26Z","timestamp":1769905766511,"version":"3.49.0"},"reference-count":19,"publisher":"Copernicus GmbH","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Bone Joint Infect."],"abstract":"<jats:p>Abstract. Introduction: Calcium pyrophosphate deposition disease (CPPD), or pseudogout, is rare in prosthetic joints, but can mimic prosthetic joint infection (PJI) according to case reports. The purpose of this case series is to describe the demographics, presentation, management, and outcomes of a cohort of these patients seen at our academic medical center.Methods: Patients with post-implant pseudogout, who were evaluated at our medical center between January 1, 2000 and June 30, 2016, were identified from our EHR. Data pertaining to demographics, presentation, management, and outcomes were abstracted, and patients were categorized into two groups based on presence of concomitant infection along with positive CPDD findings in synovial fluid.Results: 22 patients were included. 90.9% of cases involved a TKA. The most common indication for arthroplasty was degenerative joint disease. Only four patients had a history of previous gout or pseudogout, three of which belonged to the group with no evidence of concomitant joint infection. Clinical features for patients without concomitant infection included pain (100%), swelling at the joint (88.9%), redness (33.3%), fever (22.2%), and decreased range of motion (100%). 45.5% of patients received antibiotics prior to joint aspiration (44.4% of patients with negative synovial fluid cultures, 46.2% of patients with concomitant infection).Conclusion: Our study suggests similar clinical presentation between post-implant pseudogout and PJI. Among patients with pseudogout as well as in those with PJI, the first dose of antibiotics should not be given before sampling for synovial culture. Unfortunately, many patients receive antibiotics prior to culture ascertainment, which raises concern for antibiotic overuse.\n                    <\/jats:p>","DOI":"10.7150\/jbji.29983","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T05:32:33Z","timestamp":1546925553000},"page":"20-26","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Presentation, Management, and Prognosis of Pseudogout in Joint Arthroplasty: A Retrospective Cohort Study"],"prefix":"10.5194","volume":"4","author":[{"given":"Merit P.","family":"George","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Floranne C.","family":"Ernste","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Tande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Osmon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tad","family":"Mabry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie F.","family":"Berbari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3145","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Maradit-Kremers H, Larson DR, Crowson CS. et al. Prevalence of total hip and knee replacement in the United States. The Journal of Bone and Joint Surgery. 2015;97:1386\u20131397. [PMC free article]","DOI":"10.2106\/JBJS.N.01141"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Tande AJ, &amp; Patel R. Prosthetic joint infection. Clinical Microbiology Reviews. 2014;27:302\u2013345. [PMC free article]","DOI":"10.1128\/CMR.00111-13"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Osmon DR, Berbari EF, Berendt AR. et al. Diagnosis and management of prosthetic joint infection: Clinical practice guidelines by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2013;56:e1\u2013e25.","DOI":"10.1093\/cid\/cis803"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Neame RL, Carr AJ, Muir K, &amp; Doherty M. UK community prevalence of knee chondrocalcinosis: Evidence that correlation with osteoarthritis is through a shared association with osteophyte. Annals of the Rheumatic Diseases. 2003;62:513\u2013519. [PMC free article]","DOI":"10.1136\/ard.62.6.513"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Felson DT, Naimark A, Anderson J. et al. The prevalence of knee osteoarthritis in the elderly: The Framingham Osteoarthritis Study. Arthritis &amp; Rheumatism: Official Journal of the American College of Rheumatology. 1987;30:914\u2013918.","DOI":"10.1002\/art.1780300811"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"MacMullan P, &amp; McCarthy G. Treatment and management of pseudogout: Insights for the clinician. Therapeutic Advances in Musculoskeletal Disease. 2012;4:121\u2013131. [PMC free article]","DOI":"10.1177\/1759720X11432559"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Rosenthal AK, &amp; Ryan LM. Calcium pyrophosphate deposition disease. New England Journal of Medicine. 2016;374:2575\u20132584. [PMC free article]","DOI":"10.1056\/NEJMra1511117"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Abderrazak A, Syrovets T, Couchie D. et al. NLRP3 inflammasome: From a danger signal sensor to a regulatory node of oxidative stress and inflammatory diseases. Redox Biology. 2015;4:296\u2013307. [PMC free article]","DOI":"10.1016\/j.redox.2015.01.008"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Reuben PM, Wenger L, Cruz M, &amp; Cheung HS. Induction of matrix metalloproteinase-8 in human fibroblasts by basic calcium phosphate and calcium pyrophosphate dihydrate crystals: Effect of phosphocitrate. Connective Tissue Research. 2001;42:1\u201312.","DOI":"10.3109\/03008200109014244"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Yahia SA, Zeller V, Desplaces N. et al. Crystal-induced arthritis after arthroplasty: 7 cases. Joint Bone Spine. 2016;83:559\u2013562.","DOI":"10.1016\/j.jbspin.2016.01.006"},{"key":"ref11","unstructured":"Khalfaoui MY. Crystal arthropathy of the prosthetic joint. J Ost Arth. 2016;1:111. [Google Scholar]"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Khalfaoui MY, &amp; Yassa R. Crystal arthropathy following knee arthroplasty: A review of the literature. International Journal of Orthopedics. 2015;2:411\u2013417. [Google Scholar]","DOI":"10.17554\/j.issn.2311-5106.2015.02.113"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Harato K, &amp; Yoshida H. Pseudogout in the early postoperative period after total knee arthroplasty. The Journal of Arthroplasty. 2013;28:374.e9\u2013374.e11.","DOI":"10.1016\/j.arth.2012.03.017"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Hirose CB, &amp; Wright RW. Calcium pyrophosphate dihydrate deposition disease (pseudogout) after total knee arthroplasty. The Journal of Arthroplasty. 2007;22:273\u2013276.","DOI":"10.1016\/j.arth.2004.11.022"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Holt G, Vass C, &amp; Kumar CS. Lessons of the week: Acute crystal arthritis mimicking infection after total knee arthroplasty. British Medical Journal. 2005;331:1322\u20131323. [PMC free article]","DOI":"10.1136\/bmj.331.7528.1322"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Kobayashi H, Akizuki S, Takizawa T. et al. Three cases of pseudogout complicated with unicondylar knee arthroplasty. Archives of Orthopaedic and Trauma Surgery. 2002;122:469\u2013471.","DOI":"10.1007\/s00402-002-0414-7"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Levi GS, Sadr K, &amp; Scuderi GR. Bilateral pseudogout 8 years after bilateral total knee arthroplasty. Orthopedic Clinics of North America. 2012;43:e59\u2013e62.","DOI":"10.1016\/j.ocl.2012.07.009"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Sonsale PD, &amp; Philipson MR. Pseudogout after total knee arthroplasty. The Journal of Arthroplasty. 2007;22:271\u2013272.","DOI":"10.1016\/j.arth.2006.10.004"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Kocyigit F, Kuyucu E, &amp; Kocyigit A. Monoarticular hip involvement in pseudogout. Case Reports in Rheumatology. 2015;2015:1\u20133. [PMC free article]","DOI":"10.1155\/2015\/302389"}],"container-title":["Journal of Bone and Joint Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jbji.copernicus.org\/articles\/4\/20\/2019\/jbji-4-20-2019.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T09:17:01Z","timestamp":1596532621000},"score":1,"resource":{"primary":{"URL":"https:\/\/jbji.copernicus.org\/articles\/4\/20\/2019\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,1]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.7150\/jbji.29983","relation":{},"ISSN":["2206-3552"],"issn-type":[{"value":"2206-3552","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,1]]}}}